What injury can change
A fracture can leave a crooked bony vault, a depression, a wider dorsum or asymmetry. At the same time the septum may be displaced and the nasal valve narrowed. Outer alignment and the inner airway are therefore assessed in the same examination.
An old photograph from before the injury helps understand the starting point, but it is not a drawing that can be restored mechanically.
Acute injury and late reconstruction are not the same
A fresh fracture is assessed in the timeframe of emergency or early trauma care. This page concerns lasting deformity or breathing trouble after the acute phase has passed.
Realistic aims of surgery
The aim is to improve axis, proportions and airway, but a post-traumatic nose may keep asymmetry of bone, skin and soft tissue that cannot be fully removed. Those limits are stated before a decision.
Questions after nasal injury
Can the nose be returned exactly to how it looked before the injury?
Sometimes the earlier axis and proportions can be approached, but present bone, cartilage, skin and scar limit the result.
Are breathing and appearance addressed together?
They can be planned together when both problems are structural and the findings allow it.