Broken Nose (Nasal Fracture) Recovery Guide

What should I expect?

In a closed reduction, the bones are moved back into place without any cuts on the outside of the nose. Afterward, expect:

• Mild bleeding from the nose for the first few days.
• Nasal pain and congestion. You may feel more stuffed up than before because of swelling, and splints if you have them.
• Numbness of the upper front teeth. This almost always goes away within a few weeks.

What about splints?

• You may have soft plastic splints inside your nose, held in place by a stitch. They come out at your first post-op visit.
• You may have a splint on the outside of your nose, held on with tape and surgical glue. It also comes off at your first post-op visit.
• If the outside splint falls off early, gently place it back on your nose and secure it with medical tape from a pharmacy.

How do I care for my nose?

• Saline spray: use 2 sprays of nasal saline in each nostril every 2 to 3 hours while awake (about 5 or 6 times a day) until your follow-up visit.
• Afrin (oxymetazoline): you may use it as needed for bleeding and congestion for 3 to 5 days, then stop.
• Sleep with your head raised for the first 3 nights: raise your head and shoulders about 30 to 45 degrees, using a foam wedge, 2 or 3 pillows under your upper back and head, or a recliner. Keep doing it longer if it helps you breathe.
• A cold pack over the nose and cheeks eases swelling. Wrap a cold pack or a bag of frozen peas in a thin towel and hold it on for 15 to 20 minutes, then off for at least 20 minutes. Repeat as often as you like while awake for the first 48 hours. Rest it lightly; do not press on the nose.
• Mild bleeding: tape a piece of gauze under your nose and change it as needed.
• Do not blow your nose for the first week, and sneeze with your mouth open.

How should I manage pain?

Most people have mild to moderate pain that over-the-counter medicine controls well. Acetaminophen and ibuprofen together work better than either one alone.

• Acetaminophen (Tylenol): 1,000 mg every 6 hours, no more than 4,000 mg in 24 hours (or 3,000 mg if your package says so, or if you have liver problems or drink alcohol regularly).
• Ibuprofen (Advil, Motrin): 400 mg every 8 hours with food, or naproxen (Aleve): 1 tablet (220 mg) every 8 to 12 hours with food, no more than 3 tablets in 24 hours. They do not appear to increase bleeding after nasal surgery. Skip them if you have a stomach ulcer or kidney disease, or if your surgeon told you not to take them.
• If we prescribed medicine, take it exactly as directed.
• If you take aspirin or a blood thinner, follow your surgeon’s instructions on when to restart it.

When can I get back to normal?

• If you had sedation or general anesthesia: for 24 hours, do not drive, drink alcohol, use machinery or sign important papers. After general anesthesia, we recommend having an adult stay with you the first night.
• No heavy lifting or strenuous exercise for 2 weeks. Light jogging is fine.
• Your nose is fragile for at least 6 weeks while the bones heal. Avoid anything that could injure it during this time.
• For sports, see the timeline below.
• If your breathing or the shape of your nose is still not right once the swelling has gone down, tell us. A later procedure is sometimes needed.

What these limits mean: heavy lifting means anything over about 10 pounds (a gallon of milk weighs about 8), such as a full laundry basket, a case of water or a suitcase. Strenuous activity means anything that makes you breathe hard, strain or sweat: weight training, yard work, hard cycling or sports (light jogging is fine). Walking, light housework, desk work and showering are fine. When the limit ends, start at about half your usual effort and build up over a week; if bleeding starts, stop and rest.

When can I play sports again?

These are general timelines for after a broken nose is set. Every injury is different, so check with us before you go back to any sport that could hit your face, and follow your surgeon’s advice if it differs.

• A protective face mask, often custom-fitted, lowers the chance of breaking the nose again while it heals. Ask us about one before returning to a contact sport.
• Get out of the game and call us if your nose is hit again and becomes more crooked, bleeds heavily, or you have trouble breathing through it.

When should I call?