Ultrasonic rhinoplasty
A lot of patients come to us asking about the latest technological advances in rhinoplasty.
Rhinoplasty is one of the most challenging and complex surgeries that a plastic surgeon can perform and it requires constant practice and training.
Today we introduce a technique we have been using for a while now:
The ultrasonic rhinoplasty
WHAT IS AN ULTRASONIC SCALPEL?
The ultrasonic scalpel is made up of:
a generator, a transducer and a terminal where the different kinds of tips are placed to make different cuts.
HOW DOES IT WORK?
The cut is produced by the vibration of a high-frequency head. This vibration produces a precise cut at bone level.
WHAT MAKES AN ULTRASONIC RHINOPLASTY DIFFERENT?
In conventional rhinoplasty, the bony hump (the little bone) was taken out using chisel and a hammer. This can be quite traumatic to the tissue as it can damage not only the bone but also the skin and the mucous membrane.
With ultrasonic rhinoplasty we use an ultrasonic scalpel that just cuts the bone and not the skin o mucus.
WHY DOES IT CUT OTHER TISSUES?
It has a special vibration that coincides with the bone tissue allowing the bones to move, with minimal bleeding and regarding the skin and nasal mucus.
This is why we place the tip over the skin or mucosae, so it will not produce any effect.
IS IT MORE PRECISE?
It is highly precise, it does a millimetric and very precise cut, as for scars the only visible one is the one on the columella (between both nasal cavities) and then after 2-3 months it is imperceptible.
IS THERE LESS SWELLING?
This technique helps us to have less swelling and in consequence have less pain and less bruising. Swelling depends on different aspects: patient’s personal character, time of the year, and the medication the patient takes. But generally speaking, the ultrasonic rhinoplasty reduces the swelling remarkably.
To summarize:
- More precision, we know exactly where and when to cut. Scarring is more controlled and aimed.
- Less swelling, as tissues are preserved.
- Less pain, as there is less swelling and less trauma.
- As a consequence, recovery is much faster.
- Better results: due to a more precise and predictable technique.
CAN ALL RHINOPLASTIES BE ULTRASONIC?
The treatment of the hump and lateral fractures that are always necessary can be done with an ultrasonic scalpel.
The only limitation in using the ultrasonic scalpel is that the rhinoplasty must be OPEN (with a small incision between the nasal cavities that after a few months it is imperceptible).
CAN A CLOSED RHINOPLASTY (WITHOUT CUTTING BETWEEN THE NASAL CAVITIES) BE ULTRASONIC?
We are developing new ends and advances that can be used in ultrasonic rhinoplasty in a closed way but it is still necessary to do a small cut in the columella (area between the blowholes) to do an correct ultrasonic rhinoplasty.
NO MORE HAMMER AND CHISEL?
The hammer and chisel so many patients fear and causes much swelling and bruises, we have left behind, increasing the patients comfort.
The use of the hammer not only causes more swelling but also a lack in precision and unsatisfying results.
In case of doing a CLOSED rhinoplasty, we will still need to use the hammer and chisel, what will cause more swelling and bruises in the beginning.
IN WHICH CASES DO WE RECOMMEND AN ULTRASONIC RHINOPLASTY?
This surgery is especially recommended for people that want:
- To improve the respiratory function
- Change the shape and look of the nose
- Increase or reduce the nose’s volume
- Elevate or lower the nasal tip
- Correct congenital (by birth) or developed (by a previous rhinoplasty or by an accident)
PREVIOUS PLANNING TO SURGERY:
We take special pictures from all possible angles, so the patient and surgeon can evaluate together the possible treatment options in a simulation.
The simulation by computer allows us to see possible changes. It is also a useful tool so the patient can see how his/her face will look after surgery and get an approximate idea. Bearing in mind this is only a guidance.
With these special pictures, we can plan a precise surgery with means, in order to get the result as closest as possible to the simulation, always within the nose structure and skin possibilities.
It is common to receive patients that have doubts on how his/her face or nose will look after surgery as they do not want their face to change much and that they will not be recognized and this is why the simulation is a great tool to orientate them in terms of results and achievements in a more graphic and didactic way.
ARE THERE DIFFERENCES IN THE POSTOP?
As we said previously, the possibility of bruising is smaller. But if they do appear, they will go away as fast as in other rhinoplasties: from 7-15 days.
Swelling is also minor, if there is, it will be swollen for a week and then it will go down faster.
This makes the post-op easier to handle and makes it possible to go back to your normal day to day faster as there is not much swelling.
Some residual swelling can continue in the tip and osteotomy a few months after surgery, so we have to be patient and wait for the final result of the procedure.
WHAT ELSE SHOULD I KNOW ABOUT THE POSTOP?
DO YOU USE NOSE PLUGS?
We do not use conventional plugs, we use a special silicone splint that allows us to BREATH after surgery, increasing the patient’s comfort.
WHEN DO WE TAKE OUT THE PLASTER AND STICHES?
The nasal splint and stiches are taken out after 7 days. Until then you must keep the stiches clean and avoid them to form a scab.
WHEN CAN WE EXERCISE AGAIN?
20 days after surgery we could start with soft exercise in the lower body like bicycle or leg exercising. 30 days after we can do almost any kind of exercise: go to the gym, swimming, running.
For contact sports such as boxing, judo, basketball, soccer we should at least wait for 3 months or use some type of rigid facial protection (mask).
WHEN CAN I USE GLASSES?
You should wait at least 1 month to use glasses that rest on the nose, in case of needing them, we recommend to use contact lenses or we will explain how to hold them so they do not fall over the fractured zone.
WHEN CAN I DRIVE?
You should wait at least 20 days, ideally 1 month to drive after surgery.
WHEN WILL I SEE THE FINAL RESULT?
After one month you can see an approximate result but after surgery swelling can persist up to 6 months and in some cases 1 year, depending always on the patient’s scarring.
So, you have to be patient and follow all of the surgeon’s recommendations to have the best result.
Do you have any other doubt about the rhinoplasty?
You can write to us so we can talk about this in a future article.
