Is ultrasonic rhinoplasty better & is there less chances of developing a bony callus?

Question

Hello, I was wondering if there is any difference in the results of a rhinoplasty when using ultrasonic tools vs traditional tools. Also, is there less chances of developing a bony callus with ultrasonic rhinoplasty ? Thank you

Anil R. Shah, MD · Answer

Hello,

The best choice for a rhinoplasty is the surgeon not the tools. Some advantages of ultrasonic tools are increased precision and visibility however there is actually more swelling with ultrasonic than traditional approaches. Bony callus can occur with either one. Rhinoplasty is a procedure of details and it is important to pick somebody that pays attention to details.

Gurkan Kayabasoglu, MD · Answer

Hello. A very good and experienced surgeon can achieve a good result even with the worst equipment.

But of course, some technologies are being developed to make working easier. Piezo technology was invented for both the patient's healing process and the ease of operation for doctors. Thanks to piezo, more delicate incisions can be made, and healing occurs faster. Edema and bruises are definitely less, so we say piezo accelerates healing.

One golden rule: Please do not have the surgery when you feel uncomfortable and have doubts with a surgeon who you feel hesitated about. The point you need to be careful while searching for the best surgeon is the time between the before and after photos of your surgeon. The after pictures should be at least 1 years after the operation. Early results and intraoperative comparison photos have no value.

Secondly, please be sure that you have a good communication with your surgeon and he totally understands you. You can have more detailed information about me and ask questions about your case to my assistants from this number ( +90 533 015 95 95) . You can also book an online consultation and discuss your issues with me. Best regards.

Eric M. Joseph, MD · Answer

Some surgeons advocate the use of an ultrasonic device for performing osteotomies citing decreased downtime and swelling. We have not found a need to use an ultrasonic device after 25 years of performing rhinoplasty surgeries regularly. Thank you for this question! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. I don’t find ultrasonic rhinopasty gives any advantage at all.  There are, of course, some good surgeons who use it and some good surgeons who don’t use it. Here is  some general advice when selecting a 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

Thanapoom Boonipat, MD · Answer

Yes the ultrasonic tools is much gentler on soft tissue and more precise cut for the bone, so there's definitely less chance of unexpected fractures, and less bleeding and bruising. The result is more precision and faster recovery, and less chance of trauma which can cause the bony callus.

Onur Ergun, MD · Answer

Yes. less trauma means less callus. But the difference would be more noticable in edema and bruising

George Lefkovits, MD - Account Suspended · Answer

Rhinoplasty is a well established procedure which can lead to an excellent correction of the nose depending on the patient's initial presentation including the quality of the skin. Very few surgeons are using the ultrasound and, I am not convinced that it adds value to the procedure or to the post-op course. I think the experience and training of the surgeon are key in obtaining the desired result. You should consult with a Board Certified plastic surgeon with years of experience performing rhinoplasty. Also. you should look at lots of before and after photos by the surgeon to make surge your nasal aesthetics coincides with that of the surgeon. Good luck!

Is ultrasonic rhinoplasty better & is there less chances of developing a bony callus?

Answers (7)

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