Ultrasonic Rhinoplasty
Ultrasonic rhinoplasty uses piezoelectric instrumentation to perform precise bone cutting and sculpting during rhinoplasty.
Ultrasonic rhinoplasty is also referred to as piezo rhinoplasty or piezoelectric rhinoplasty.
Ultrasonic rhinoplasty uses a powered handpiece called a piezotome. Dr. Athré was the first adopter of the piezotome to perform ultrasonic nose jobs in Houston. He learned from Dr. Olivier Gerbault (Paris, France), who essentially invented the concept of using the piezotome for rhinoplasty procedures.
Dr. Athré's adoption of piezoelectric instrumentation reflects his ongoing evaluation of techniques that may improve surgical precision and patient outcomes.
“Dr. Athré did an amazing job on my nose. His staff treated me like family and I felt very comfortable getting the work done."
About Ultrasonic Rhinoplasty
Ultrasonic rhinoplasty uses a powered handpiece called a piezotome.
The piezotome has different bits, much like drill bits. Each bit has a different purpose. Some tips are designed to sculpt or smooth bone, while others cut or drill bone.
The piezotome uses the piezoelectric effect to generate high-frequency microvibrations at the instrument tip. Piezoelectric instruments are designed to selectively cut mineralized tissue while minimizing injury to surrounding soft tissues. The piezotome uses high-frequency microvibrations to precisely cut and sculpt nasal bone while minimizing trauma to surrounding soft tissues. This selective action is one reason piezoelectric osteotomy may result in less postoperative swelling and bruising than conventional techniques.
A common theme on many of the pages on this site is that tissue trauma leads to scarring. Reducing unnecessary tissue trauma may support healing; however, rhinoplasty healing and final results depend on multiple factors, including anatomy, surgical technique, and individual healing.
An example of the piezotome in action in a rhinoplasty surgery is shown in this video available on YouTube. The video contains graphic surgical footage and may not be appropriate for all viewers. The video demonstrates how the piezotome cuts and shapes nasal bone using high-frequency microvibrations.
Benefits of Ultrasonic Rhinoplasty
Advantages and Disadvantages of Ultrasonic Rhinoplasty
In ultrasonic rhinoplasty, piezoelectric instruments can be used instead of conventional osteotomes and rasps for selected bone-cutting and sculpting steps.
The primary advantages of the piezotome over cold instruments are:
- Precise, controlled bone cuts with less injury to adjacent soft tissues than conventional osteotomy instruments
- Potentially less bleeding and soft-tissue injury
- The piezotome uses continuous irrigation to clear debris and help limit heat generation at the surgical site. This irrigation helps limit thermal injury during bone cutting.
Studies comparing piezoelectric and conventional osteotomies have found less early postoperative pain, bruising, and swelling with piezoelectric techniques. The technology also allows precise sculpting of the nasal bones. This precision can give the surgeon greater control when performing osteotomies and reshaping the nasal bones. Recovery varies by patient and by the extent of surgery. Some patients may feel comfortable resuming certain social or work activities within the first week, although swelling and bruising can persist.
Potential limitations include additional equipment costs and a learning curve for surgeons adopting the technology. Studies have reported mixed findings regarding operative time. The bits and instruments add about $500-750 to the surgical procedure cost, and the extra operating room time adds about $500 to the cost of surgery.
Because of these advantages, Dr. Athré has incorporated piezoelectric instrumentation into his rhinoplasty practice since 2017 when appropriate to the surgical plan. Dr. Athré was among the earliest surgeons in Houston to adopt piezoelectric instrumentation for rhinoplasty.
Dr Athré learned from Dr. Olivier Gerbault (Paris, France), a pioneer in the use and development of piezoelectric instrumentation for rhinoplasty. It is a testament to Dr. Athré’s mentality to continually evolve in the hunt for the perfect rhinoplasty outcome.
Keep in mind that no single rhinoplasty technique is appropriate for every patient or every surgical situation. The appropriate technique depends on the patient's anatomy, goals, and surgical plan. These pages explain the different rhinoplasty techniques and the potential advantages and limitations of each. Rhinoplasty requires familiarity with a broad range of surgical techniques so the operative plan can be tailored to each patient's anatomy and goals. A broad surgical repertoire allows the surgeon to select or adapt techniques when an individual case requires a different approach.
Why Dr. Athré for Rhinoplasty?
Dr. Athré focuses extensively on primary and revision rhinoplasty in his Houston practice, though his patients come from all over the US, Mexico, South America, and the Middle East.
He uses contemporary techniques and adapts established approaches to each patient's anatomy and goals, with an emphasis on natural-looking results.
Approximately 75–80% of Dr. Athré’s rhinoplasty practice consists of primary rhinoplasty, while revision procedures account for approximately 20–25%. Because revision rhinoplasty often involves more complex anatomy and changes from previous surgery, this portion of his practice reflects substantial experience managing challenging secondary cases. Dr. Athré also treats revision rhinoplasty patients referred by other physicians.
Patient Review
“Dr. Athré did an amazing job on my nose. His staff treated me like family and I felt very comfortable getting the work done. He was very intuitive on what I was trying to accomplish and knowledgable enough to work through the issues involved to get the result I wanted, especially considering it was a revision surgery. The whole experience was great and helped me so much!”
