What is ultrasonic piezo rhinoplasty?

Ultrasound rhinoplasty is a revolutionary procedure that results in less bleeding, less bruising, less swelling, a faster recovery and better results. The procedure uses ultrasound technology to power small precise blades that are designed to cut and shape the nasal bones. This technology is replacing the mallet and osteotome all over the world. The specifically designed cutting tips were just approved by the US FDA and I am proud to say that I am the first and currently only plastic surgeon who is performing this procedure in New York City.

Piezo rhinoplasty is a new technique for rhinoplasty where the bones and cartilages are reduced with a grinding type machine as opposed to cutting the bone. It definitely shows promise but the photos I have seen show that it fails to adequately narrow the nose or reduce the bridge in many cases. I can see it’s place in more conservative rhinoplasty.

Hello,Thanks for your question. Ultrasonic, or piezo, rhinoplasty is the newest technology available for rhinoplasty patients. A high speed sound wave device is used to reshape the nasal bones in a more gentle way than previously practiced. Traditionally, rhinoplasty surgeons use rasps, osteotomes/mallets, and/or powered rhinoplasty instrumentation. These devices offer a more crude rendition of nasal reshaping in most people's hands. Additionally, most patients experience enhanced bruising and swelling from the use of these tools. With the refinement of the ultrasonic rhinoplasty device, patients can expect more accurate outcomes with less bruising, swelling, and social recovery. There are currently only a few surgeons in North America who offer this technology. For more information about Ultrasonic Rhinoplasty, please check out my Youtube video of case I performed recently.Thanks,Dr. Shah

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.

Hello,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!

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

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 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.

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.

Dear Koz13Thanks for the question. Piezo technology has been used in surgery for years.  There isn't enough evidence to support it as a better wayseveral 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