Immediate functional and cosmetic open rhinoplasty following acute nasal fractures: our experience with Asian noses

Wong CH, Daniel RK.

PubMed 23636623 Publisher (DOI)

What this paper says

In 25 Asian patients who had a full open rhinoplasty immediately after a fresh nasal fracture, 23 rated the result 7 or higher out of 10 at a mean 17 months, all breathed as well or better than before the injury, and 1 needed a filler touch-up.

Overview

A broken nose is usually pushed back into place and splinted; a cosmetic operation, if wanted, comes later. The authors instead set the fracture and then proceeded with a complete open rhinoplasty in the same session, correcting shape concerns the patients already had, in an Asian population where this had not been described.

Sections of note

25 Asian patients; primary functional and cosmetic open rhinoplasty immediately after acute nasal fracture.
Bony vault fractures reduced anatomically before opening the nose.
Spreader grafts stabilized the fractured or dislocated dorsal septum and straightened the nose.
Aesthetic steps according to each patient's wishes: lengthening, tip refinement, increased tip projection.
Grafts all autologous: septum, ear concha, rib, deep temporal fascia.
Mean follow-up 17 months (range 10 to 24).
Satisfaction on a 1 to 10 scale: 23 of 25 rated 7 or higher.
All patients breathing as well as or better than before injury; 1 patient (4%) had a secondary filler procedure for a slight dorsal irregularity.
Level of evidence 4.

What it means for a patient

After a nasal fracture, a wanted cosmetic rhinoplasty may be done at the same time rather than months later.
In this series results and breathing were good and only one minor touch-up was needed.
Small series, satisfaction self-rated on a simple scale, no comparison with staged treatment, and the surgeons were highly experienced.

Why this paper matters

It challenges the standard advice to wait after a fracture, at least for Asian noses where augmentation is usually part of the plan. Swelling at the time of injury can hide the true shape; how the authors managed that is not detailed in the abstract.

Terms

Acute nasal fracture: a fresh break of the nasal bones.
Closed reduction: pushing broken nasal bones back into place without incisions.
Open reduction: setting the bones through surgical exposure.
Spreader graft: a cartilage strip placed beside the septum to support and straighten the middle vault.
Deep temporal fascia: the tough layer over the temple muscle, used as a soft graft.
Bony vault: the upper third of the nose formed by the nasal bones.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Closed reduction and splinting are generally recommended in the acute management of nasal fractures. Although open reduction is recommended for more severe nasal fractures, immediate functional and cosmetic open rhinoplasty following nasal fractures has not been described for Asian noses. Objectives: The authors…”

Excerpt; the full abstract is on PubMed.