Does ultrasonic rhinoplasty yield better results then traditional rhinoplasty?

Question

Is ultrasonic rhinoplasty more advanced than traditional rhinoplasty does it yield a better final result an outcome than traditional rhinoplasty I’d like to hear a non biased answer from surgeons that specialize in rhinoplasty

Ronald J. Edelson, MD · Answer

It's not the tools that make a result good. It's the surgeon using the tools. Ultrasonic tools will only give a good result if the surgeon is skilled and experienced in rhinoplasty.

Caner Kacmaz, MD · Answer

Definitely...Ultrasonic rhinoplasty doesn't involve breaking the bone therefore there's no direct trauma to your nose. It's performed by using ultrasonic waves to reshape the nose. The process is extremely easy. Recovery time is way less than traditional rhinoplasty. Bruising and swelling are minimal. In fact, most patients do not experience bruising at all. I definitely recommend ultrasonic rhinoplasty for you. Best wishes.

Nihat Kaya, MD · Answer

The result of rhinoplasty is determined by the experience and skill of the doctor.Nose aesthetic surgery performed with ultrasonic allows you to spend the post-operative process more comfortably.Less swelling and much less bruising and swelling heals quickly

Masoud Saman, MD · Answer

First and foremost, I'd like to share with you the benefits of ultrasonic rhinoplasty, a procedure I have extensive experience with in the field. Ultrasonic rhinoplasty utilizes ultrasonic energy to precisely sculpt the nasal bones, allowing for a more controlled and refined reshaping with minimal trauma to surrounding tissues. This often translates to reduced post-operative swelling and bruising, promoting a quicker recovery. It's worth noting that while I'm utilize various approaches to rhinoplasty (Preservation, structural, ethnic, open, closed) I employ the ultrasonic device in approximately 70% of my cases. Not every patient needs it or benefits from it. This is because every individual's case is unique, and each aesthetic aspiration demands a tailored approach with the most suitable instrument.

Olivier Gerbault, MD · Answer

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.

Cem Altindag, MD · Answer

Hi, thank you for the question. To me, piezo surgery (using ultrasonic waves to cut and/or rasp the bones) yields advantage for selected cases. It is just your surgeon's preference whether using the instrument or not. The results would not be effected directly. Edema, bruising would be less although it has some risks during surgery. Regards. Dr. Cem Altindag

Rosa B. Lipin, MD · Answer

This is a great question. During my fellowship, my mentor exclusively used piezo/ultrasonic rhinoplasty for all his surgeries. I chose to use traditional rhinoplasty instruments on my cases, as I was not sure what instruments I would have available to me when I completed the program, and to this day I do not use ultrasonic rhinoplasty.
Ultimately, it is a tool. Just like an osteotome. It is the surgeon holding the instrument that determines the success of its use. Someone with excellent training who uses the piezo will have excellent results. Someone with excellent training who uses an osteotome will have excellent results. There are several papers that contradict what I just wrote, but this is based on my personal experience of seeing patients between POD 3-7 for an entire year. 
I personally did not see much difference in post surgical swelling, but perhaps slightly less bruising. Bruising is pretty uncommon in my patients-- about 2/3 have no bruising while the rest will have mild bruising that is almost absent by POD 7. 
So my advice would be: if you found a surgeon that you feel comfortable with and trust, go with that. The tool they use is not nearly as important as their training, surgical skill and technique, and shared vision with you, the patient.

Robert Ciardullo, MD · Answer

Does ultrasonic rhinoplasty give superior results? Ultrasonic tools are just that, tools. They are not a new or advanced procedure or technique but simply tools that use libration to assist in filing and cutting the tissues. The end result of any rhinoplasty is not determined by the particular type of tool that is used but by the skill of the surgeon and the experience of the surgeon and the particular characteristics of the nose he is working on. One of the worst Rhinoplasty results I have ever seen who is coming to me for a revision was done by ultrasonic technique in Europe. There will be those who get an excellent result with this technique or with other techniques. But once again this does not depend on the tools that are involved but on the surgeon and the patient.

William Portuese, MD · Answer

There are many different ways to cut through the nasal bone which include knife, scissors, ultrasonic,
or Chisel when needed for thick nasal bones. Ultrasonic is only a method of Cutting through the bone, and give the same results as all the other methods. Much more important is experience of the surgeon, not the cutting tool

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