Piezo’s ultrasonic rhinoplasty concept is not new. Piezo means pressure with the Greek derivative. The manufacturing company wants to sell these devices to plastic surgeons. They came up with the idea of applying pressure in the form of ultrasound to special tips to cut bone and contour cartilage.
To be blunt, I see no benefit to this tool over the gold standard of sharp osteotomes and grasps. As we stated in the past rhinoplasty is one of the more challenging procedures the plastic surgeons offer. It requires a great degree of knowledge, experience, and skill. There is no substitute for experience and the ultrasonic tool is no substitute for these surgeon’s attributes. The use of this tool can only be done, or best be done with the open rhinoplasty technique. Which in and of itself has drawbacks. That is why I prefer the closed technique.
These vibrating special tips in my opinion are no more or less traumatic than the gold standard of tools that we use. The step-wise procedure of creating a more refined and elegant nose has evolved over decades. The ultrasonic technique requires open and takes much longer to achieve with in my opinion no major benefit than two accuracies. In other words, I believe that the gold standard is more accurate with less damage to surrounding tissue and certainly less traumatic than the open technique. There is no proof that the ultrasonic process gives a more natural look – none.
Ultrasonic Rhinoplasty Surgery
All surgery has post-operative bruising and swelling. Furthermore, there is no significant study to demonstrate that the ultrasonic technique reduces in any way the postoperative bruising and swelling. Arnica gel in my opinion is our best tool for postoperative bruising and swelling plus elevation, & ice.
Recovery time for rhinoplasty in the immediate timeframe is not any less with the ultrasonic saw. Patient selection and the surgeon’s skill plus skin thickness are the best determining factors for the best result. Just because a company advertises a new machine that they want to sell to doctors does not guarantee your best result. Your best result is maximized first by the safety of general anesthesia and the skill and experience of the surgeon.
Therefore, when you read that the ultra-precise nose job technique results in less bruising and faster healing – don’t believe it. I disagree. Rhinoplasty remains one of the greatest ways for patients to feel better about their appearance and therefore, quality of life.
THOMAS TREVISANI, MD
BOARD-CERTIFICATION PLASTIC SURGEON
MEMBER OF THE AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
