Hello, I believe I can answer quite accurately as I've begun to do rhinoplasties in 1990 using classical osteotomes and a mallet to break bones partly blindly and did this until 2013 when I began to design and use piezo instruments for ultrasonic rhinoplasty and septoplasty that I exclusively use since then.Piezo instruments are NOT just other instruments for rhinoplasty. They allow to safely do an approach of the bony vault (either open or closed) that enable to visualize the whole bony vault and to perform not only extremely precise osteotomies under direct visual control, but also bone sculpting and reshaping (rhinosculpture) which is not possible with a traditional approach and mechanical instruments.Moreover, nasal bones are extremely different in shape, thickness, brittleness, elasticity...from one patient to another and NOTHING allows to assess those specificities except piezo instruments. The impact is paramount as the type of osteotomies and bone sculpting will not at all be the same depending on those bone characteristics. This helps to minimize the risk of bony and septal defects after a rhinoplasty.But above all piezo instruments never create unwanted radiated fracture and preserve bone stability. Whoever the surgeon, mechanical instruments may create unwanted fracture and comminution at the area where the osteotome hits the bone. This can create bone instability, collapse, irregularities, step deformities, residual hump, asymmetries, axial issues... Finally, I agree that the surgeon's experience is irreplaceable in rhinoplasty, but the use of ultrasonic instruments allows to use different approaches, techniques very precisely and gently, to design less traumatic bone and septum reshaping for structural and preservation rhinoplasty.My answer is obviously biased as I'm an advocate of ultrasonic rhinoplasty since 10 years, but I don't know lot of surgeons who have more than 20 years experience with osteotomes and rasps AND 10 years experience with piezo instruments, and who can therefore master both instrumentations and techniques.