Is ultrasonic rhinoplasty less invasive?

Ultrasonic rhinoplasty, or Piezotome rhinoplasty, is trending on social media with hundreds of thousands of searches on Instagram, but what exactly is it?

Initially developed in the early 2010s by a plastic surgeon inspired by piezoelectric surgery used in dentistry, its rationale was to address the challenges inherent in nasal bone surgery.

Understanding nasal anatomy

The nose is a complex structure with various components that must be considered when performing nasal surgery.

The nasal cavities are the hollow areas of the nose, separated by the septum, which is made of both bone and firm cartilage. The upper third is composed of bone, formed by the nasal and cheekbones. The middle third is formed of cartilage, which is stiffer in the middle of the nasal bridge and softer at the sides. The lower third, known as the nasal tip, is composed of thin cartilage tissue that arches over the nostrils.

“Ultrasonic rhinoplasty is predominantly used to address the upper third of the nose,” Mr Annakan Navaratnam explains. “Previously, we performed an osteotomy to break the bone and reshape it which can be more unpredictable. The Piezotome allows you better control to sculpt and precisely cut the nasal bones.”

During an osteotomy, hammers and bone chisels are used to reduce the width of the nose, correct asymmetries, or remove bumps. Risks include uncontrolled fractures or the creation of small bone fragments. The Piezotome advanced surgical device emits ultrasonic micro-vibrations to reshape the bones.

“Older patients particularly can benefit. The nasal bones are more fragile, and there’s a risk when fracturing and sculpting.

“Patient selection is critical. For more significant deviations or a twisted nose, it’s not always suitable. I mainly use piezoelectric technology for aesthetic refinements rather than a drastic change. It allows you to essentially sculpt the nasal bones to reduce the dorsal hump or correct minor asymmetries.

“In my NHS work, I use the Piezotome device for craniofacial cases. It’s used for patients with significant deformities or those who have had multiple revision operations as it is precise and effective while sparing the adjacent tissue structures, compared to conventional surgery.”

Is there less downtime after ultrasonic rhinoplasty?

Ultrasonic rhinoplasty are mainly used in open procedures (external rhinoplasty). This involves an incision at the base of the nostrils before the skin is lifted from the underlying bone and cartilage structure.

The Piezotome device emits ultrasonic waves to gently cut the nasal bones with less damage to the surrounding soft tissue. It can also prevent what’s called ‘radiating fracture lines’ which are lines that extend from the point of impact.

However, “any type of rhinoplasty procedure will result in some degree of swelling and bruising. The recovery time varies depending on the individual’s healing process,” warns Annakan. There is less damage to the small blood vessels, which can result in less bruising around the eyes and across the cheeks.

The significant benefit of ultrasonic rhinoplasty is greater precision and control. For more advice on whether you’re suitable, call +44 (0)203 627 2918 or email secretary@annakan.co.uk to arrange a consultation with rhinoplasty surgeon Mr Annakan Navaratnam.