Rhinoplasty (nose surgery) is one of the most complex procedures in facial plastic surgery, requiring careful reshaping of bone and cartilage to achieve balanced results. Piezoelectric technology offers surgeons an alternative tool for reshaping the nasal bones, providing greater precision when working on hard tissue.
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) practising in Sydney who uses ultrasonic rhinoplasty techniques for suitable candidates seeking nose reshaping surgery.
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What is Piezoelectric Rhinoplasty?
Piezoelectric rhinoplasty—also called ultrasonic rhinoplasty—uses specialised surgical instruments that produce high-frequency vibrations to cut and shape bone and firm cartilage. Unlike traditional tools used in rhinoplasty, piezoelectric devices work at frequencies that affect hard tissue while leaving the surrounding soft tissue largely unharmed.
The technology converts electrical energy into precise vibrations at ultrasonic frequencies (typically 25,000-30,000 vibrations per second). These vibrations allow for highly accurate bone cutting with submillimetre precision.
This technology was first developed for jaw and dental surgery before being adapted for nose surgery. The ability to cut hard tissue while protecting soft tissue is the main advantage over traditional instruments.
How Does Ultrasonic Rhinoplasty Differ from Traditional Techniques?
Traditional Rhinoplasty Tools
Traditional rhinoplasty uses chisels, rasps, and powered instruments to reshape nasal bones. These tools require direct force to fracture or shape bone. While effective when used by experienced surgeons, traditional instruments have certain characteristics:
- Bone cutting relies on controlled breaking rather than precise sculpting
- Surrounding soft tissue receives some trauma during bone work
- Small fractures and bone splintering can occur unpredictably
- The surgeon works partly by feel rather than direct sight
Piezoelectric Instrument Benefits
Ultrasonic instruments offer different properties:
Selective Cutting: The ultrasonic frequency affects bone and calcified cartilage while largely avoiding softer structures like blood vessels, nerves, and the nasal lining. This happens because soft tissues absorb the ultrasonic energy differently than hard bone.
Controlled Shaping: Rather than breaking bone, piezoelectric instruments gradually remove tissue through vibration. This allows for precise contouring without creating unpredictable fracture lines.
Better Visibility: Reduced bleeding during bone work can improve the surgeon’s view, potentially allowing more accurate shaping.
Less Tissue Damage: Protecting the blood supply and surrounding soft tissue may lead to less swelling and bruising after surgery in some patients.
Understanding What to Expect
It is important to understand that piezoelectric rhinoplasty is simply a different method for reshaping bone—not an entirely different procedure. Final results depend on surgical planning, technique, and how your body heals rather than which instruments are used. The benefits relate mainly to precision during surgery rather than guaranteed better results. A skilled surgeon using traditional tools can achieve excellent outcomes, just as piezoelectric technology requires proper expertise to deliver its benefits.
What Can Ultrasonic Rhinoplasty Treat?
Piezoelectric technology is especially useful for specific nose surgery tasks involving bone:
Dorsal Hump Reduction
The nasal bridge consists of both bone (upper portion) and cartilage (middle portion). Removing a bump on the bridge traditionally involves filing or chiselling the bony part. Piezoelectric instruments allow for precise, gradual reduction with controlled depth, potentially lowering the risk of removing too much or creating an uneven surface.
Narrowing a Wide Nasal Bridge
Making a wide nose narrower requires controlled breaks in the nasal bones (called osteotomies). Traditional techniques use chisels or saws to create these breaks. Piezoelectric osteotomies can produce more predictable results with potentially less bone movement and reduced soft tissue damage.
Correcting Bony Irregularities
Bumps, dips, or unevenness along the nasal bridge—whether present from birth or caused by injury—can be addressed through precise ultrasonic shaping. The gradual removal allows careful correction of problems that might be difficult with traditional tools.
Reshaping the Nasal Bones
Comprehensive reshaping of the bony nose structure—including narrowing, straightening, and profile changes—is well suited to piezoelectric technology, combining multiple bone-shaping steps in a single procedure.
Improving Breathing
Beyond cosmetic changes, piezoelectric instruments can help with functional rhinoplasty that addresses structural causes of blocked breathing. A deviated septum involving bony parts and enlarged turbinates can be treated using ultrasonic technology. The same careful assessment and planning apply to functional procedures as to cosmetic rhinoplasty.
Revision Rhinoplasty
Piezoelectric instruments can be particularly helpful in revision rhinoplasty (secondary nose surgery), where scar tissue and changed anatomy from previous surgery make bone work more challenging. The precise cutting action allows controlled changes to previously operated areas. However, revision rhinoplasty is more complex and carries higher risks regardless of the technique used, and patients should understand that secondary procedures are more challenging than first-time surgery
Who is a Suitable Candidate?
Not all rhinoplasty patients need or benefit from ultrasonic instruments. The technology is most helpful for patients whose surgical plan involves significant bone work, including substantial bridge reduction, narrowing wide nasal bones, correcting bony irregularities, and revision rhinoplasty involving previously operated bone. Concerns limited to the nasal tip or soft cartilage may not require ultrasonic technology, and Dr Turner assesses each patient individually to determine whether piezoelectric instruments offer meaningful advantages for their specific situation.
Candidates for any rhinoplasty should be in good overall health, have finished growing (typically after age 18), and have realistic expectations about what can be achieved. Smoking significantly slows healing, so patients must stop all tobacco and nicotine products for at least six weeks before and after surgery. As required by Australian regulations since July 2023, patients considering cosmetic surgery need a psychological assessment to ensure suitability. The overall cost of rhinoplasty depends on surgical complexity and operating time rather than which instruments are used, with Dr Turner providing detailed pricing during consultation based on individual needs.
The Surgical Procedure
Ultrasonic rhinoplasty is performed under general anaesthesia in a fully accredited hospital, with continuous monitoring by a qualified anaesthetist. The procedure typically takes 2-4 hours depending on complexity.
Surgical Steps
Dr Turner typically uses an open rhinoplasty approach for procedures using piezoelectric instruments:
- Making the Incisions: A small cut across the columella (the tissue between the nostrils) combined with cuts inside each nostril provides access to the underlying nose structure.
- Lifting the Skin: The nasal skin is carefully lifted from the underlying bone and cartilage, exposing the nose framework for direct viewing.
- Bone Work with Piezoelectric Instruments: With the nasal bones clearly visible, Dr Turner uses ultrasonic instruments to reduce the bridge, make osteotomies, and shape the bone as needed.
- Cartilage Work: Nasal tip refinement, septum straightening, and cartilage grafting are done using standard techniques, as piezoelectric technology does not offer advantages for soft cartilage work.
- Closing and Splinting: After all changes are complete, incisions are closed with fine stitches. External splints and internal supports are placed to hold the new nose shape during early healing.
Recovery Following Ultrasonic Rhinoplasty
Recovery from piezoelectric rhinoplasty follows a similar pattern to traditional rhinoplasty, though many patients experience less bruising due to reduced soft tissue trauma during bone work. The external nasal splint stays in place for 10-14 days, during which moderate swelling and some bruising around the nose and eyes are normal. Discomfort is managed with prescribed pain medication, and patients should keep their head elevated, avoid blowing their nose, and skip strenuous activity. Most patients can return to desk work by week two, though glasses should not rest on the nose and contact sports must be avoided during early healing.
Most visible swelling settles within the first three months, allowing return to normal activities including moderate exercise. However, the nasal tip may remain slightly firm during this time as deeper swelling continues to resolve. Complete resolution of all swelling takes 12 months or longer, particularly for patients with thicker skin. Final nose shape becomes fully apparent only after this extended healing period, making patience essential. Dr Turner monitors progress through scheduled follow-up appointments to ensure healing is on track.
Risks and Potential Complications
All surgical procedures carry risks, and rhinoplasty—regardless of which instruments are used—involves specific potential complications that must be understood before proceeding. General surgical risks include bleeding, blood collection, infection, reactions to anaesthesia, and slow wound healing. Rhinoplasty-specific risks include prolonged swelling, unevenness or asymmetry, temporary numbness, breathing changes, hole in the septum (rare), skin colour changes, dissatisfaction with appearance, and the possible need for revision surgery.
While piezoelectric instruments may reduce certain risks associated with traditional bone work, they do not eliminate surgical complications. Heat injury to tissue is possible with prolonged instrument use, though proper technique minimises this risk. The technology requires specific expertise, and results depend significantly on surgeon experience with ultrasonic instruments. Dr Turner discusses all potential risks during consultation, ensuring patients understand both the benefits and limitations of any proposed approach. For more information about rhinoplasty procedures, please visit our Rhinoplasty Surgery page or contact us to arrange a consultation.
This content is suitable for an 18+/adult audience only.
Individual results will vary from patient to patient and depend on factors such as genetics, age, and healing capacity. All surgical procedures carry risks and require a recovery period. This information is provided for educational purposes and does not constitute medical advice. Patients should obtain multiple opinions and carefully consider all benefits and risks before proceeding with any surgical procedure.
