Piezo or normal osteotomy?

Hello and thank you for your question. In my experience, there is not much difference between the two techniques. I would not decide your surgeon based on this, but rather based on your surgeon’s overall body of work. Here is some general advice on selecting a good surgeon. I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up. Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag. If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag. Long-term results are much more meaningful than on table results or 1 week post-op results.

I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thank you for your question. I have used both techniques. I find them almost interchangeable. I tend to use the piezoelectric for a more complete osteotomy on my preservation cases and an external noncontinuous traditional osteotomy on my open structural cases. Both work well and have very little consequences. I hope it helps. Best wishes to you.