Cosmetic Concerns Related to the Posttraumatic Nose without Nasal Obstruction

Because of its prominent position on the facial skeleton, the nose is commonly injured. Though significant trauma can result in nasal obstruction, there is also considerable concern for potential cosmetic deformity. Repairing traumatic deformities is complex and can involve all aspects of the nose, including the bony and cartilaginous framework as well as the soft tissue envelope. Trauma can result in deflection, asymmetry, and deformity of the bony nasal dorsum, midvault, and nasal tip. Any serious nasal trauma places patients at risk for complications that may include nasal septal hematoma, septal perforation, and possible cerebral spinal fluid leak. Unrecognized or untreated septal hematomas can result in cartilaginous septal necrosis followed by saddle nose deformity. Though damage to structural scaffolding is often the cause of cosmetic deformity following nasal trauma, the nasal soft tissue envelope is also commonly affected. This can result in lacerations, avulsions, and traumatic tattooing. The following will discuss the evaluation, diagnosis, and management of these cosmetic concerns relating to nasal trauma.