Does Piezo cause more/less swelling & complications than traditional bridge correction techniques?

Question

Ultrasonic/Piezo revision rhinoplasty. Firstly, is Piezo thought to cause more or less swelling and complications than traditional hammer and chisel for nasal bridge correction (no hump just lowering dorsum)? Piezo is the 'gold standard' by most but one surgeon has advised against since they said it can cause more swelling than traditionally used methods - is this right? Secondly, is bone 'rasped' with the Piezo device, and thirdly, how are osteotomies performed differently with Piezo compared to traditional methods?

Yannis Alexandrides, MD, FACS · Answer

So, a Piezo uses ultrasonic energy to alter the surface and the consistency of the bone. It has become, for a lot of surgeons, performing Rhinoplasty the gold standard, so you've right. This is because it reduces swelling, improves accuracy and minimises injury to the soft tissue. This is because it does not work on the soft tissue and can only be applied to the bone or cartilage.

However, like any new technology it requires proper training form the surgeon performing it, so there's a earning curve to that needs to be taken before a doctor performs it and masters it.

It has different tips and there are some tips which we would called 'Raspers' which are a more traditional instrument.

Finally for osteotomies, I perform with a special source that the Piezotome enables.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. Today's world Piezo technique is the most common rhinoplasty type. With this method the patient will have less swelling and bruises also edema. This way the post op rhinoplasty is much more easy. Best Regards!

Jennifer Goodrich, MD · Answer

Good afternoon.Any of the US devices do create heat, which CAN cause local tissue trauma, however a surgeon who is accustomed to using these devices can really mitigate if not eliminate the risk, so it is mostly based on surgeon experience and preference. As far as dorsal height take down, the US devices essentially "melt" away the bone, so no rasping. Osteotomies are performed in the same way, by "melting" the bone, it will wind up removing a small sliver of bone whereas in general, the mallet and osteotome do not remove bone during osteotomies, unless you are intentionally trying to remove a wedge of bone to narrow the vault. Both are great techniques; I use both. It just depends on surgeon preference and experience.

Does Piezo cause more/less swelling & complications than traditional bridge correction techniques?

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