What is ultrasonic piezo rhinoplasty?

What is ultrasonic piezo rhinoplasty? Is it better than usual open and close rhinoplasty ? Is it being done in North America? Thank you

Doctor Answers 9


This technique is new and not entirely accepted by the entire rhinoplasty community and was initially promoted by a French rhinoplasty surgeon . Time will tell if it becomes mainstream. One concern with it is that it required much more extensive exposure and stripping of the soft tissues and periosteal lining at the sides of the nose and these layers are normally kept intact with traditional methods and provide stability against collapse of bony segments  which may be a concern with piezosurgery

Ultrasonic Piezo Rhinoplasty

This is a type of equipment used during rhinoplasty that I would see absolutely no value in. With thirty years of expertise using the techniques and instruments I use I can perform rhinoplasty surgery with certainty of the results. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

ultrasonic rhinoplasty

This is not mainstream medicine, and we are not aware of anyone using this technology in the United States.  A rhinoplasty procedure involves not only making the required changes to both nasal bones, but making changes to the upper lateral cartilages, the septum, and the lower lateral cartilages.  Some rhinoplasty procedures involve cartilage grafting techniques, while others involved cartilage removal techniques.  Choose   your surgeon based on extensive experience, not a un-proven technique.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

Piezo Saw


This is just a saw to cut nasal bones.  It does not obviate the need for everything else required to change the appearance of the nose. So, open or close incisions need to be made, as well as rasping bones, removing excess cartilage, graft cartilage, and use permanent shaping sutures. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

New rhinoplasty technology?

having performed rhinoplasty for 40 years without a problem using the normal instrumentation for rhinoplasty I see no advantage to this technology. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Piezoelectric instruments in rhinoplasty surgery

Piezoelectric instrumentation in surgery is a wonderful new addition to rhinoplasty.  It allows the rhinoplasty surgeon to contour nasal bones and selectively create "controlled" fractures, which can eliminate contour irregularities and asymmetries often caused by traditional techniques.

John Layke, DO, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 50 reviews

Ultrasonic osteotomies

Thanks for your post. The Piezosurgery technique uses ultrasound energy to perform osteotomies (bone cuts) during rhinoplasty. The most common method to change the position of nasal bones during surgery is via lateral osteotomies performed internally with a rigid osteotome. Alternatively, the bone can be broken externally via a percutaneous approach.

I do not have any significant experience with this technique as I have not experienced any problems with conventional osteotomies. I hope this helps.

Mark Been, MD
Barrington Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Piezoelectric surgery and rhinoplasty

Dear Koz13

  • Thanks for the question. 
  • Piezo technology has been used in surgery for years. 
  •  There isn't enough evidence to support it as a better way
  • several surgeons recently reported their experience at a national rhinoplasty meeting and maybe in the next few years, your questions can be bettered answered after more research is completed. 

Best Wishes 

Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews


The piezo ultrasonic technology is used for some surgeons to fracture, shape or remove some areas of the nasal bone. It is just a small part of the rhinoplasty. There seems to be some advantages using this technology but also some disadvantages. Many surgeons can deliver the same results using traditional techniques a performing the osteotomies with chisels, or reshaping a dorsal hump with rasps, or other mechanical devices like a guarded burr.

Juan Carlos Fuentes, MD
Mexico Plastic Surgeon
4.7 out of 5 stars 66 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.