Ultrasonic rhinoplasty or classic rhinoplasty?
First of all, it is necessary to define what are an ultrasonic rhinoplasty and a classic rhinoplasty.
Ultrasonic rhinoplasty is the use of instruments developed by Dr. Gerbault in 2013 that vibrate on an ultrasonic frequency to reshape the nasal bones in a gentle, selective and controlled way. These instruments have made it possible to develop rhinoplasty techniques that have changed the game in both structural and preservation rhinoplasty:
- Sculpture of the entire nasal pyramid under direct visual control thanks to the extended open or closed approach ;
- Hump treatment by very progressive polishing to control the profile line and width of the nose, but also to reduce asymmetries of the nasal pyramid ;
- Extremely precise bone incisions without risk of destabilizing the bones in order to mobilize them to reduce a nose that is too wide, or asymmetrical ;
- Very precise and controlled bone resection for certain types of Preservation rhinoplasty or for the correction of certain nasal asymmetries.
These same properties of gentleness and precision without risk of uncontrolled fracture allow a use for nasal septum surgery, not only for septoplasty but also for all dorsum preservation techniques, thus avoiding certain complications of these techniques.
Finally, ultrasonic rhinoplasty makes it possible to correct certain nasal obstructions related to turbinates or the shape of the nasal aperture, but also to harvest in some cases grafts from a rib without risking one of the most feared complications in these cases: pneumothorax.
Classic rhinoplasty includes many techniques:
- Old-fashioned resection techniques (hump, cartilage ...) without reconstruction or support, which often lead to progressive aesthetic deformations over time and functional issues ;
- Structural rhinoplasty techniques where after directly resecting the hump, it is reconstructed through different remodeling and support processes (same for the tip of the nose) ;
- Preservation rhinoplasty techniques for which the nasal pyramid is pushed down into a block to correct a hump, a deviation or an asymmetry...
Instruments used in classical rhinoplasty (mechanical instruments) are called osteotomes, bone chiesels, hammer, rasps, saws. They break or rasp bones in jerks with blows that can create uncontrolled fractures (called radiated fractures) and thus destabilize the bones. These bones can thus move or sink without precise control, and lead to irregularities, deformations associating hollows and bumps, asymmetries ....
Ultrasonic rhinoplasty is therefore not the use of piezoelectric instruments instead of mechanical instruments but a concept and techniques that allow to reshape the nasal bones in a gentle and non-traumatic, precise, controlled way, without risking causing uncontrolled fractures or destabilizing the nasal bones.
You should know that it is not because the classic rhinoplasty instruments (osteotomes, bone chiesels, rasps ...) are used that the result will be bad or that there will be complications. In the same way, it is not because ultrasonic rhinoplasty is used that the result will be good. The experience of the surgeon is another essential element in the result of a rhinoplasty, the choice of techniques also, and finally the dialogue with the patient in order to understand his wishes and explain what is possible or not is quite essential.
However, ultrasonic rhinoplasty techniques allow less experienced surgeons to quickly acquire high precision and control in bone contouring and nasal septum management when the techniques are properly performed. This last point is also essential: it is important to be well-trained in ultrasonic rhinoplasty to master all ultrasonic rhinoplasty techniques. This also applies to preservation rhinoplasty techniques. At present, these two rhinoplasty groups are very popular among surgeons who perform rhinoplasty, but also on social networks. They can be put forward by surgeons who promote these popular procedures without having fully trained on them or without mastering them. In these cases, aesthetic and / or functional complications are much more frequent. It is not the techniques that are in question, but the mastery of them.
Which one to choose?
Finally, the most important is to consult 2-3 rhinoplasty specialists before deciding on a rhinoplasty, whether or not they use ultrasonic rhinoplasty. It is necessary to feel in tune with the surgeon whose operative act will simply decide the future, that is to say the appearance of the nose for the rest of life, but also the breathing function of the nose. However, ultrasonic rhinoplasty has established itself on the five continents in 10 years as a reliable, gentle, precise technique to reshape all types of nose.