The day after the incident may be too soon, as the nose may still be too swollen for effective examination. However, within five days following nasal trauma, the swelling typically decreases and the nose is still mobile enough to attempt a closed reduction. A small percentage of patients will need no further repair. If open surgery is required, precision is critical. The surgeon can work under actual visualization by making three small incisions and peel the skin of the nose up toward the forehead, as in the two cases described.
Several options are available if additional cartilage is needed.
In some cases, the patient s own cartilage from the septum or ear may be used. Cadavaric cartilage is another safe source. Many synthetic products such as Medpor or Gortex are available, and rejection of such materials is rare. If taken in stages, surgical repair may not need to be extensive. If the patient does well after reconstruction of the nose itself, usually patients will find most sinus problems resolved.