UltraUltrasonic Rhinoplasty by Dr Turner in Sydney & Brisbane
Rhinoplasty remains one of the most technically demanding procedures in facial plastic surgery, requiring meticulous reshaping of bone and cartilage structures to achieve harmonious results. Piezoelectric technology represents an evolution in how surgeons approach the bony components of the nose, offering an alternative to traditional instruments for nasal skeleton work.
Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) with practices in Sydney and Brisbane. With over a decade of experience in facial plastic surgery, Dr Turner employs ultrasonic rhinoplasty techniques for appropriate candidates who require bone modification as part of their nose reshaping.
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Understanding Ultrasonic Rhinoplasty
What is Piezoelectric Rhinoplasty?
Ultrasonic rhinoplasty—sometimes referred to as piezoelectric or piezotome rhinoplasty—utilises specialised surgical instruments that generate high-frequency vibrations to cut and sculpt the nasal bone with precision. The technology operates by converting electrical energy into ultrasonic oscillations, typically at frequencies between 25,000 and 30,000 cycles per second. These micro-vibrations allow the surgeon to work on calcified structures whilst largely sparing adjacent soft tissues from direct trauma.
Initially developed for maxillofacial and dental applications, piezoelectric technology was later adapted for rhinoplasty. The fundamental principle involves selective tissue interaction—the ultrasonic frequency affects dense bone and calcified cartilage, whilst soft tissues, blood vessels, and mucous membranes absorb the energy differently and remain relatively undisturbed.
How Does It Differ from Conventional Rhinoplasty Techniques?
Traditional rhinoplasty involves the use of osteotomes (surgical chisels), rasps, and powered burrs to modify nasal bones. These instruments rely upon controlled mechanical force to create fractures or abrade bone surfaces. Whilst effective in experienced hands, conventional instrumentation has specific characteristics:
- Bone modification occurs through controlled fracturing rather than gradual sculpting
- Force transmission can affect the surrounding soft tissue structures
- Fracture lines may extend unpredictably in some cases
- The surgeon often works partially by tactile feedback rather than direct visualisation
Piezoelectric instruments offer different properties for bone work. The selective cutting action targets mineralised tissue whilst the overlying periosteum, blood vessels, and nasal mucosa experience reduced direct trauma. Rather than creating fracture lines, ultrasonic instruments gradually remove bone through vibration, permitting continuous sculpting with millimetre-level control. The reduced bleeding during bone work may improve surgical visibility in certain situations.
Am I a Suitable Candidate for Ultrasonic Rhinoplasty?
Ideal Patient Characteristics
Not every rhinoplasty patient requires or benefits from ultrasonic instrumentation. The technology proves most advantageous when the surgical plan involves significant work on nasal bones rather than cartilage-only modifications.
Candidates who may benefit from piezoelectric techniques include those requiring:
- Substantial dorsal hump reduction involving the bony bridge
- Narrowing of wide nasal bones through osteotomy
- Correction of bony irregularities, asymmetries, or post-traumatic deformities
- Revision rhinoplasty where previous surgery has altered bone architecture
- Combined functional and aesthetic procedures addressing bony septal components (see Functional Rhinoplasty)
Concerns limited primarily to the nasal tip, the lower cartilaginous structures, or soft tissue require standard cartilage-modification techniques rather than ultrasonic instrumentation. For comprehensive information about nose reshaping options, please visit our Rhinoplasty Surgery page. Dr Turner assesses each patient individually to determine whether piezoelectric instruments offer meaningful advantages for their specific anatomical situation.
Medical Considerations
Appropriate candidates for any rhinoplasty procedure should:
- Be in good general health without uncontrolled medical conditions
- Have realistic expectations regarding achievable outcomes
- Understand both the benefits and limitations of the proposed approach
- Be a non-smoker or willing to cease all nicotine products for at least six weeks before and after surgery
Smoking significantly impairs tissue healing and increases complication rates. Patients must demonstrate commitment to smoking cessation before proceeding.
AHPRA and Regulatory Requirements
As mandated by Australian regulations introduced in July 2023, patients considering cosmetic surgical procedures require a psychological assessment to confirm suitability. This assessment evaluates realistic expectations and emotional readiness for surgery. Dr Turner views this requirement as an essential safeguard that supports good outcomes rather than an obstacle to treatment.
How is Ultrasonic Rhinoplasty Performed?
Anaesthesia and Facility
Ultrasonic rhinoplasty is performed under general anaesthesia in a fully accredited hospital facility. A qualified consultant anaesthetist provides continuous monitoring throughout the procedure. Dr Turner does not compromise on the surgical environment—facial surgery requires precision and attention to detail that can only be delivered safely in properly equipped facilities with experienced support teams.
Duration
Surgical duration typically ranges from 2 to 4 hours, depending on complexity and the extent of required modifications. Procedures involving significant bone work, revision surgery, or combined functional correction may extend toward the longer end of this range.
Surgical Approach
Dr Turner typically employs an open rhinoplasty approach when utilising piezoelectric instruments, as this provides optimal visualisation of bone structures during ultrasonic sculpting.
Step 1: Incision Placement A small incision is created across the columella (the tissue bridge between the nostrils), combined with incisions inside each nostril. This access permits complete exposure of the underlying nasal framework.
Step 2: Elevation of Soft Tissue Envelope The nasal skin and soft tissues are carefully elevated from the underlying bone and cartilage, exposing the nasal skeleton for direct visualisation.
Step 3: Bone Modification with Piezoelectric Instruments With the nasal bones clearly visible, Dr Turner utilises ultrasonic instruments to perform the planned bone modifications. This may include dorsal hump reduction through gradual sculpting, osteotomies (controlled bone cuts) for narrowing the nasal bridge, correction of bony irregularities or asymmetries, and refinement of the bony profile. The piezoelectric device permits precise, incremental bone removal under direct vision, allowing accurate contouring without unpredictable fracture patterns.
Step 4: Cartilage Modification Tip refinement, septum straightening, and any required cartilage grafting are performed using standard techniques. Piezoelectric technology does not offer advantages for soft cartilage work, so conventional methods remain appropriate for these components.
Step 5: Closure and Splinting Following completion of all modifications, incisions are closed with fine sutures. External nasal splints and internal supports are placed to maintain the new nose shape during the initial healing period.
Recovery and Aftercare
Recovery from ultrasonic rhinoplasty follows a similar pattern to traditional rhinoplasty, though many patients experience less bruising due to less soft-tissue trauma during bone work. The external nasal splint remains in place for ten to fourteen 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 refrain from strenuous activity. Most patients return to sedentary work within two weeks, 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 twelve 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 proceeds appropriately.
Risks and Complications
All surgical procedures carry inherent risks that must be understood before proceeding. General surgical risks include bleeding, haematoma formation, infection, adverse reactions to anaesthesia, and delayed wound healing. Rhinoplasty-specific risks include prolonged swelling, asymmetry or irregularity, temporary or rarely permanent numbness, changes to breathing, septal perforation (rare), skin discolouration, dissatisfaction with aesthetic outcome, and the possible need for revision surgery. Approximately 1 in 10 rhinoplasty patients may require revision procedures regardless of the technique used.
Whilst piezoelectric instruments may reduce certain risks associated with conventional bone work—exceptionally soft tissue trauma and unpredictable fracture patterns—they do not eliminate surgical complications. Potential thermal injury can occur with prolonged instrument application, though proper technique minimises this risk. The technology requires specific expertise, and outcomes depend significantly upon the surgeon’s experience with ultrasonic instrumentation. Dr Turner discusses all potential risks during consultation, ensuring patients understand both the benefits and limitations of any proposed approach before making informed decisions.
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