Traditional Rhinoplasty
Surgical Technique and Incisions:
Traditional rhinoplasty, a well-established surgical procedure, involves the skilled use of manual instruments like scalpels and bone chisels. The surgeon may choose either an external (open rhinoplasty) or internal (closed rhinoplasty) approach based on the specific requirements of the case. In most cases an open approach is the preferred option. During open rhinoplasty, an incision is made across the columella (the strip of skin between the nostrils), allowing for better visibility and access to the nasal structures.
Bone Manipulation and Reshaping
In traditional rhinoplasty, one of the primary goals is to reshape the nasal bones to achieve the desired aesthetic and functional outcomes. Surgeons often manually break and reposition the bones to correct issues such as a dorsal hump, deviated septum, or asymmetry. This method, while effective, can lead to more bruising and a potentially longer recovery period due to the trauma inflicted on the nasal tissues.
Precision and Skill
The success of traditional rhinoplasty heavily relies on the surgeon’s experience and skill. With tactile senses and visual judgment, the surgeon sculpts the nose to meet the patient’s expectations. The result depends on judgement about what to remove and what to leave, which is why two surgeons can do the same operation and get different noses.
Ultrasonic rhinoplasty
How the instruments work
An ultrasonic instrument shapes bone with controlled high-frequency vibration instead of a chisel or rasp. It cuts bone and leaves the soft tissue next to it largely alone, so the surgeon can sculpt the bones of the nose precisely and with much less force than a hammer and chisel need. That control is the reason I use it.
What changes for you
The nasal bones can be reshaped more precisely, and with less force through the surrounding tissues. I use ultrasonic instruments for the bone work in every rhinoplasty I do, so there is no choice for you to make between the two. Neither technique shortens the twelve months it takes for the shape to settle, and swelling and bruising still follow the operation.
What it does not change
The instrument does not decide the result. The result depends on my judgement about what to remove, what to keep and how to support the nose, as it does with any technique. Ultrasonic instruments are also a different matter from preservation rhinoplasty, which is a separate approach to the bridge of the nose and is explained on its own page.
Learning curve
Ultrasonic instruments take practice, and it is a different kind of practice from the chisel. I had to learn it. Whichever approach your surgeon uses, ask about their experience with it, and choose a specialist surgeon with a track record in the work they propose. A Fellow of the Royal Australasian College of Surgeons (FRACS) ENT surgeon is the standard to look for.
For how I use it in practice, see my page on ultrasonic rhinoplasty, or contact my rooms to arrange an appointment. More about the whole operation is on the rhinoplasty page, what recovery involves is on the recovery page, and fees and rebates are on the cost page.
Before and after
Patients whose main concern was the bridge of the nose, with the time since surgery stated on each photograph.
