Interview with Dr. Gerbault in Paris Match magazine
A decade ago, the term 'ultrasonic rhinoplasty' did not exist, nor were there any specific instruments for rhinoplasty. The surgical approaches and ultrasonic rhinoplasty techniques developed by Dr. Gerbault are now being utilized worldwide, a decade after their inception.
Ultrasonic Rhinoplasty : Customized Nasal Remodeling
Are aesthetic nose surgeries common?
Rhinoplasties, totaling over 15,000 per year, are the third most commonly performed operation in France, following breast surgeries and liposuctions. Considering the high number of people who express dissatisfaction with their noses, this might seem relatively low. The traditional rhinoplasty procedure is to blame, as it is traumatic: the nose bones are blindly broken with a hammer and chisel, resulting in bruising, significant swelling, and an extended recovery period. This approach often leads to common complications such as residual bumps, asymmetries, and overly hollowed noses. Patients, however, desire a natural-looking nose, a quick return to work and normal life, without any visible signs of surgery, and this is achievable with ultrasonic rhinoplasty!
How does it work?
Ultrasonic waves are produced by piezoelectric instruments, similar to those used by dentists to descale teeth. The extremely rapid vibrations they produce allow for a gentle and precise reshaping of the nose bones without damaging the surrounding tissues. The miniaturized instruments that I have developed in a decade-long collaboration with the French laboratory Actéon enable us to change the shape and position of the nose bones in a highly controlled manner. This involves sculpting, polishing, making precise incisions for correction, and even suturing when necessary. However, doing this requires visibility. Hence, I had to break a taboo in rhinoplasty by lifting the skin covering the bones on the sides of the nose. This can be achieved through small incisions either inside the nose or on the skin between the nostrils, which become invisible after surgery. The entire bone structure of the nose becomes visible and can be worked on gently.
What are the right indications for it? How does the procedure unfold?
Ultrasonic rhinoplasty can address all aesthetic and functional nose problems involving the bones: wide noses, asymmetrical noses, humps, crooked noses, overly prominent or long noses, short noses, so-called "ethnic" rhinoplasties, secondary rhinoplasties (previously operated noses), or those performed after the age of 40-45 when the nasal pyramid bones are more fragile and brittle. It's also applicable in complex cases resulting from accidents. The procedure typically takes about two hours under general anesthesia. Patients usually go home the same day. The recovery is straightforward: there are almost no marks or bruising after the procedure, and minimal pain. There is no need for a heavy plaster or packing after the procedure. The person can immediately wear glasses, blow their nose, exercise, as the nose bones haven't been weakened. Complications are rare in experienced hands, but learning the technique is essential. In this regard, it's important to ensure the operator's experience and competence.
Is this technique widely used?
It has rapidly gained popularity worldwide, especially in the Middle East where aesthetically challenging noses are common, notably in Turkey since 2014, and in several European countries thereafter. It received approval from US authorities in 2018, and many French surgeons now utilize it. Testament to its success, I have received several awards in Europe and the USA for this invention, including the prestigious Jacques Joseph Award presented last year by the Rhinoplasty Society, recognizing the most significant contribution of the decade in rhinoplasty.