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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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October: Breast Cancer and Domestic Violence Awareness Month

This month marks two very special observances that seek to both protect and empower women

National Breast Cancer Awareness Month is celebrating 25 years of awareness, dedication and empowerment. Even many pro football players are wearing pink shoes, socks and towels to heighten awareness for this devastating disease.  Breast cancer affects women young and old. While Breast cancer isn’t something that I come across as a treating physician since I confine my practice to the face and neck, this subject still holds dear to my heart. I know excellent physicians who dedicate their skills to helping victims. 

I dedicate my expertise to another dreadful cause for human suffering that is also being recognized this month – Domestic Violence.  Every 9 seconds a woman is battered in the U.S. by her partner. Over 500,000 cases of domestic violence are reported each year; however experts say that the incidence may be as high as three times that number. This applies to teenage relationships as well.

We are doing our part by participating in the Face to Face program of the American Academy of Facial Plastic and Reconstructive Surgery. The organization offers complimentary consultations, surgery, counseling and support to shattered victims of domestic abuse who otherwise would not be able to afford reconstructive or facial plastic surgery. My office is taking action against domestic violence and offering pro-bono reconstructive surgery through Face to Face. Facial trauma is a visual reminder that can never be hidden. The brave lady below met with me last spring through the Face to Face program. She had reconstructive surgery of her nose and a deviated septum. Her new nose means so much more to her than just ‘a new nose’. She no longer sees her past while glancing into the mirror each morning. She now has a new career, a beautiful family, and a new reflection on life.

If you know someone who is being abused, you must get them help and out of the relationship. It’s been documented that abuse is most likely to escalate. If you know someone who has been or might be subject to domestic violence, have them call the Women in Distress 24 – Hour hot line at 954-761-1122 or visit

This is the month to protect and empower women who fall victim to two devastating conditions: Breast cancer and domestic violence. There are many ways that you can take a stand and spread awareness on both issues. You can walk a marathon, contribute to charities, or, like many teams on the NFL, show your support by wearing pink! Steven J. Pearlman, MD, FACS

Nasal Fracture, Broken Noses in New York

What should you do when you break your nose?

This sounds simple but even some doctors don’t know how a specialist in facial plastic surgery treats broken noses. First, there are only two true emergencies when you break your nose. First and most obvious is a non-stop nosebleed. Obviously, get to the nearest ER or specialist and have them treat your nose, which likely requires topical decongestants and/or nasal packing for a few days.

The other emergency that rarely occurs when you break your nose is called a septal hematoma. The same very delicate blood vessels in the septum that may bleed can also bleed under the “skin” or mucosa of the nasal septum. This causes the septum to blow up like a balloon on both sides of the nose with blood that can’t get out. If this blood isn’t drained (by a specialist), it can cause the septal cartilage to get weak and collapse over a few months time causing a saddle deformity (severely scooped nose). So, if you have trouble breathing after breaking your nose, the inside needs to be checked for a hematoma, preferably within 24 hours.

Now to address the nasal bones: If you do break your nose use ice right away and keep in place, 20 minutes on and 10 minutes off for the first two days. If the only problem is shifting of the nasal bones to the side, they can be repositioned by a minor surgical procedure called a “closed reduction.” Unless you are seen right after trauma, the nose is usually too swollen to do this right away. However, after about two weeks, the bones start to heal so the ideal time is somewhere between three days and two weeks. Beyond two weeks, we may need to wait two months for the bones to fully heal before re-breaking.

If there is a simultaneous deviated septum, cartilage heals differently. I prefer to wait at least six to eight weeks before treating the crooked septum. So, if both a nasal bone fracture and deviated septum are present, I delay fixing the broken nose for the stated minimum of six to eight weeks then re-break it when I fix the septum so the patient only has one operation instead of two (closed reduction then septoplasty).

As for a rhinoplasty after sustaining a broken nose, I prefer waiting at least two to three months to let everything heal and settle if I we are to do more than straighten the nasal bones and a deviated septum.

Treatment for a broken nose can be a simple surgical procedure. But if not treated properly, the consequences can be more severe.

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