Differences between ultrasonic rhinoplasty and traditional rhinoplasty

Ultrasonic rhinoplasty is an innovative technique that differs from others when it comes to moderating the nasal bony skeleton, as it is done in a more precise and predictable way (by ultrasound) and is born as an alternative to traditional osteotomies.

Ultrasonic rhinoplasty and conventional rhinoplasty

There is no reason why there should be any difference in the aesthetic results or in the correction of a respiratory dysfunction provided by both techniques. Ultrasonic rhinoplasty surgery is exactly the same as conventional rhinoplasty, except for the fracture of the nasal bone itself and the removal or lowering of the bony nasal dorsal hump.

In a rhinoplasty the cartilages and bones of the nose are modified (sometimes it is also necessary to act on the nasal septum or turbinates) in order to change its shape and / or size (width, length, greater protection, etc.); that is, the nose can be profiled or contoured almost completely. All these possibilities are similar in these two rhinoplasty techniques.

The difference lies in the fracturing and filing of the dorsum and in the “tools” used for this purpose. When the nasal pyramid needs to be narrowed, or when the dorsum of the nose is devoid of a dome after elimination of the hump, the bone must be fractured in order to mobilize it.

Traditionally, it was performed by percutaneous osteotomy (the one we prefer in the case of classic rhinoplasty versus classic endonasal), with a tool called osteotome or chisel with which we proceed to make a puncture in the line we want to fracture, so that after applying pressure, the bone breaks just in that piece, through an incision of 1 or 2 millimeters on the sides of the nose. The problem with osteotomy is that there is a risk that the bone may fracture in the wrong direction, in an unpredictable manner, or that an uncontrolled fracture may occur in several fragments, which we call comminuted fracture.

Then, ultrasonic rhinoplasty is different because it is performed with a piezotome that allows cutting the bone in a controlled manner, without damaging other tissues; this makes the osteotomy can be practically drawn, and reduces the chances of the bone fracturing in an inappropriate place. The ultrasonic piezotome is an instrument that can cut the bone using ultrasound, and does so selectively, i.e., it only cuts bone and cannot damage the surrounding soft tissues.

Advantages and disadvantages of ultrasonic rhinoplasty

• Less risk of unpredictable bone fracture.
• Less trauma during dorsal removal.
• Much less risk of bleeding, and therefore hematoma.
• Greater dissection of the area.
• Filing of the dorsum mechanically, with the piezobicturí.

Advantages and disadvantages of conventional rhinoplasty

• Increased risk of unpredictable bone fracture, undesirable bone cracks or asymmetries may appear.
• Greater risk of hematomas.
• Less dissection of the area.
• Manual filing of the dorsum, with the periosteal file.

Is it necessary to use plugs in ultrasonic rhinoplasty?

The use of plugs is not determined by the technique but is given by other reasons such as:

1. To contain inflammation.
2. When the septum is repositioned, to avoid contact between the turbinates and the nasal septum.
3. When a septoplasty is performed, to avoid septum hematomas.
4. To contain internally the bones of the nose. However, and due to the very low probability of bleeding with ultrasonic rhinoplasty, in many occasions the use of plugs can be avoided.

Recovery from ultrasonic rhinoplasty

Recovery after both rhinoplasty techniques is similar as long as there are no fracture complications or hematomas. It is not a painful recovery and does not require painkillers. Six days after the intervention, the visible swelling will have diminished a lot if there are no hematomas, but these can slightly delay the healing if they occur. In addition, nasal swelling will also be influenced by individual patient characteristics.