Ultrasonic Rhinosculpture

What exactly is ultrasonic rhinosculpture?


Ultrasonic rhinoplasty is a new process that precisely reshapes the nose with new miniaturized instruments developed by Dr. Gerbault  in 2013.

  • Ultrasonic rhinoplasty treats the bony part of the nose to correct a hump or a nose that is too wide, or asymmetric. It also helps to correct other aspects of the nose such as: a deviated nasal septum, bone asymmetry, a base that is too prominent, etc…
  • Until now, surgeons use instruments created over 100 years to remove a hump, or to narrow the nose. In other words, the bones are broken blindly, with no possibility to precisely control the bone position, orientation and shape. Sometimes the bones don't break where expected, and leads to aesthetic defects that are impossible to hide or even breathing issues.
  • This is why Dr. Gerbault developed these miniaturized instruments that vibrate thanks to an ultrasonic unit (Piezotome - Acteon). It acts like an electric toothbrush compared to a regular tooth brush.
  • This technique, called piezochirurgie, is known for 20 years, and is widely used in other fields, particularly among dentists where it has demonstrated its efficiency and perfect safety. Dr. Gerbault adapted it for rhinoplasty and designed inserts with Acteon specificaly for rhinoplasty. He also created different techniques to reshape or mobilize bones, to treat the septum...
  • The softness and the precision of this technique allows to extend the nose undermining to the whole bony vault, described by Dr. Gerbault as the full open approach. It allows an accurate bone reshaping under direct vision, and not blindly as usually performed for rhinoplasty.
  • Another major advantage of this technique is to avoid in many cases to break the nasal bones : bones are just thinned and polish gradually to achieve a perfect result and very smooth feeling. In other cases, the bones can be very accurately moved, orientated and reshaped, for example to narrow the nose...
  • Ultrasonic rhinoplasty deals mainly with the bony part of the nose to treat a hump, narrow a nose, treat nasal asymmetries, but also with septum issues...

Ultrasonic rhinoplasty is currently used on the five continents. Some of the best rhinoplasty experts around the world have adopted those techniques of bone reshaping and septoplasty, for aesthetic rhinoplasty and functional rhinoplasty. Dr. Gerbault has developed different techniques of ultrasonic rhinoplasty, has published them in 2016 and 2018, and has designed different instruments with the company: Acteon. He's still developping instruments for septoplasty and closed ultrasonic rhinoplasty.

Dr. Gerbault teaches every month plastic surgeons, facial plastic surgeons and maxillofacial surgeons from France and abroad, during workshops or during meetings.

Malformation due au Syndrome de Binder vue de profil avant-apres
Bosse sur le nez avec pointe large et asymétrique vue de profil avant-apres

What are the benefits of ultrasonic rhinosculpture compared to classical rhinoplasty?


There are at least 6 indisputable advantages for the ultrasonic rhinoplasty:

  • First, the surgeon controls accurately everything because he can see the whole nasal pyramid, which is impossible to do with conventional surgery.
  • Bony cuts, whenever necessary, are perfectly controled, without the risk of unwanted fractures which frequently happend with usual techniques
  • Bones can be sculpted and reshaped, which is impossible with conventional instruments. In many cases, bones don't need to be broken, as it's done most often in usual rhinoplasty.
  • Thin and fragile bones can be treated, as well as brittle bones (especially for mature patients) or bones that have been already broken previuosly during a nasal trauma or a surgery.
  • Nasal bones asymmetry can be accurately treated, which is very difficult with conventional methods.
  • Finally, the patients recovery is very quick, with nearly no bruising, and patients can return to work after a week.
Traditional Rhinoplasty
Traditional Rhinoplasty

Ultrasonic Rhinoplasty
Ultrasonic Rhinoplasty

There are specific disadvantages to this technique?


The only inconvenience is that the surgery is a little longer (about 10 min):

  • Because there are much more options to reshape nasal bones.
  • One can not only cut the bone,
  • But also change their shape to correct humps in a perfect and natural way.
  • Bones position can also be visually checked to avoid a nose that is too pinched or overly broad.

rhino01

Is ultrasonic rhinosculpture expensive?


No, at least not directly. However some surgeons pay for the OR where they operate on an hourly basis, which may increase the cost of the operation. This is not the case for Dr. Gerbault and Dr. Makhoul.

What are the recommendations for someone who wants to undergo nose surgery?


Rhinoplasty is a very particular field in cosmetic surgery.

  • Therefore, it is important for patients to visit 2 or 3 specialized surgeons who understand both the aesthetic and functional aspects of the nose.
  • It is also preferable to do simulations with different views on the patient's nose, to be well informed on the desired result. This insures us that the patient does not end up with a nose that does not correspond with what they desire.
  • Finally, it is essential that your surgeon carefully examines the inside of your nose to detect risk factors for respiratory problems, and correct them afterwards during the operation.

In the end, it is important not only to trust your surgeon, but also to search for all evidence regarding the experience of your rhinoplasty surgeon before you start.