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Nose & sinus
Broken nose
It is not uncommon for the nose to be first point of contact during any form of facial trauma. There are two broad structures that can be affected: the bony upper part of the nose and the cartilaginous septum or lower part of the nose.
Clinical content by the surgeons of Sydney ENT Clinic · Updated October 2026
When an injury first occurs, there is bruising, bleeding and swelling that makes it hard to assess whether any of these structures have been broken and are out of position. After a 2-5 days, if there is a clear distortion of the nose or the persistent inability to breathe through the nose then an ENT review is wise. In the first 21 days it is possible to have simple procedure to manipulate the bones (and/or the septum). This manipulation is performed under anaesthesia in a hospital as day patient and involves either no incisions or a small incision on the septum only. Repositioning the bones and cartilage structures will allow them to heal very close to their original position. This usually results in excellent cosmesis and function. If the bones and cartilage are allowed to heal in the distorted position, then a formal rhinoplasty or open nasal reconstruction will be required later to correct it. (hyperlink to Rhinoplasty section)
Tested at Kogarah on the day
Allergy testing and objective nasal airway measurement are available in Suite 5 with our allergist and scientists from the group’s nasal airway laboratory, and a sinus CT can be arranged at Lumus or Castlereagh Imaging within a few hundred metres of the clinic.
Frequently asked questions
How soon after breaking my nose do I need to be seen?
Within the first 14 days. In that window the broken fragments are still mobile and the bones can simply be pushed back into place (a closed reduction). After about two weeks they begin to set, and a straightforward manipulation is no longer possible. If the nose is bleeding heavily, you cannot breathe through either side, or there is a swelling on the septum inside the nose, be seen straight away.
Can a broken nose be straightened without surgery?
Not really — there is no easy fix. A cast on the outside will not lift a depressed nasal bone, and manipulating the bones under local anaesthetic is very uncomfortable, so most patients are offered a short general anaesthetic for a closed reduction, in which the bones are moved back into position without any cuts. Once a nose has been fractured you cannot undo it; all we can do is set it up to heal as straight as possible. Most people get a good result. A small group whose bones heal out of line go on to need a formal rhinoplasty later.
Do I need an X-ray or CT scan for a broken nose?
We almost always arrange an X-ray or CT scan. Apart from confirming the fracture, it shows whether there was a pre-existing bony deformity — and that changes the plan. A closed reduction after a recent injury only works if all the fragments are loose and mobile; it will not straighten a nose that was already significantly crooked before the injury. In that situation a closed reduction is not worth doing, and the better course is to wait until the risk of further injury (the sporting season, for example) has passed and then consider a formal nasal reconstruction.
What if my nose has healed crooked from an old injury?
Then the bones and septum have set in the wrong position and manipulation will not move them. This is when a reconstructive septorhinoplasty is needed — an operation that re-breaks and realigns the nasal bones, straightens the septum and rebuilds the support of the nose, to restore both breathing and shape. See our rhinoplasty and nasal reconstruction page.
Who treats this at Kogarah
Complex and tertiary sinus and skull base cases: Prof Richard Harvey, Darlinghurst.
For GPs
Send the referral directly to the specialist’s rooms. If the right surgeon isn’t obvious, send it to any of us and we will place it.
Referral information