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 8

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.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 196 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.

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
4.7 out of 5 stars 126 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 78 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 32 reviews


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

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.

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 11 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.