Ultrasonic nose job: rhinoplasty with Piezotome

Written in association with: Mr Florian Bast
Published: | Updated: 06/09/2023
Edited by: Laura Burgess

Rhinoplasty means the modification of the shape of the nose. This may be combined with a septoplasty if nasal breathing is impaired (modification of the septum), which is then called a functional septorhinoplasty. In traditional rhinoplasty surgery, instruments known as rasps, osteotomes, chisels and hammers were used to reshape the nasal bones.

We’ve asked consultant otolaryngologist and facial plastic surgeon Mr Florian Bast to explain a new tool that he uses in his clinic when performing nose surgery, which is known as the Piezotome, or the “ultrasonic nose job.”

 

Why is rhinoplasty performed?

Rhinoplasty surgery is commonly performed because of:

  • Fracture of the nasal bone or another nasal trauma
  • Hump or saddle nose
  • Bent or buckled nose structure
  • Nose too long or too short
     

How does Piezo Scaler work?

The Piezotome generates an ultrasonic modulated frequency of between 28 and 36 kHz. With these ultrasonic vibrations, we may cut and shave bone, with limited risk of damaging soft tissue such as cartilage, nerves, blood vessels and skin.
 

How does the Piezo technique for rhinoplasty work?

If the nasal bones need re-shaping during a rhinoplasty, they are either broken, cut or shaved. Traditionally for many years, this has been performed using rasps and chisels. The Piezo technique allows us to cut, shave, sculpt and polish the bone under direct vision, with minimal collateral damage.
 

What are the advantages of an ultrasonic nose job?

During the surgery, the surgeon can make direct, precise, and selective incisions whilst preserving soft tissue. As these incisions are precise, they allow for maximal protection of bone volume. After surgery, patients generally experience less pain, swelling and bruising. The bone regeneration, wound healing, and recovery is fast, leading to a stable and long term result.
 

What are the risks of the Piezo techniques for rhinoplasty?

As the bone shaping is performed under direct vision, the surgical technique used to allow this means there is a small increased risk of swelling in the first 48 hours after surgery.

 

 

Do not hesitate to book a first consultation with Mr Bast if you’re considering rhinoplasty.

By Mr Florian Bast
Otolaryngology / ENT

Mr Florian Bast is a London-based consultant ENT surgeon. Prior to this Mr Bast was appointed as an ENT consultant at the University of Berlin, Germany. Mr Bast completed his higher surgical training at the University of Heidelberg and the University of Berlin, Germany and became a specialist in otorhinolaryngology, head and neck surgery in 2011. In 2014, Mr Bast completed the prestigious craniofacial and facial-plastic fellowship at Chelsea and Westminster Hospital, London.

Mr Bast specialises in aspects of rhinology and facial plastic surgery, including the treatment of chronic rhinosinusitis, functional and aesthetic septo-rhinoplasties, and treating patients with snoring problems and obstructive sleep apnoea. He is also extensively trained in the use of Neuromodulators and Dermal Fillers. Mr Bast is a frequent lecturer at national and international conferences and is also widely published in his areas of expertise.

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