Piezoelectric Instruments in Rhinoplasty: Revolutionizing Bone Management

The use of piezoelectric instruments (PEI) in rhinoplasty has transformed the procedure over the past few years. These innovative tools only affect bones and stiff cartilages, leaving soft tissues like skin, mucosa, soft cartilages, vessels, and nerves unharmed.

Advantages of Piezoelectric Instruments in Rhinoplasty

Unlike traditional mechanical osteotomes, PEI do not create radiated fractures on bones, allowing for a more precise and controlled approach. This enables surgeons to:

• Safely extend bony vault dissection through an extended subperiosteal bony vault undermining
• Visualize the entire bony vault to assess anatomic variations and mobilize each bone precisely with piezo saws
• Sculpt bones precisely with special rasps or scrapers, allowing for a more refined rhinosculpture
• Perform bone osteosynthesis with sutures to stabilize bones in primary or secondary rhinoplasty

PEI also facilitate incremental bone removal without damaging underlying soft tissues, preserving osseocartilaginous attachments at the keystone area and avoiding step deformities. Furthermore, they do not damage the upper lateral cartilage (ULC), enabling anatomic reconstruction of the dorsum after non-conservative hump removal.

Piezoelectric Instruments in Rhinoplasty: A Disruptive Technology

Piezoelectric instruments have revolutionized bone management in rhinoplasty, shifting from a blind treatment where bones are broken to an open approach where bones are reshaped and mobilized with perfect control. This technology simplifies hump removal and osteotomies, while achieving a perfectly smooth dorsum and keystone area.

Expertise in Ultrasonic Rhinoplasty

Dr. Olivier Gerbault, a pioneer in ultrasonic rhinoplasty, has been developing techniques and piezo instruments since 2013. In this video, he demonstrates various rhinoplasty techniques achieved through piezosurgery, including:

• Precise osteotomies and positioning of bones
• Bone sculpting (rhinosculpture)
• Bony vault and keystone area smoothing
• Bone stabilization
• Conservative septoplasty with long intact pieces of bony septum harvesting
• Easy and safe rib graft harvesting

Surgical Case Studies

The video features various surgical case studies, including:

• Primary male patient: overprojected nose, wide bony vault, and wide asymmetric tip, septal deviation
• Primary male patient: wide, asymmetric nose on an asymmetric face, severe septal deviation, bony hump
• Primary female patient: nasal hump, overprojected drooping nasal tip
• Primary female patient: hump reduction on a slightly too wide bony vault, overprojected tip
• Secondary female patient: asymmetric nose with no tip support, valve dysfunction
• Primary male patient: twisted nose with dorsal hump, septal deviation

This comprehensive video tutorial is available in HD streaming or on 4 DVDs, offering approximately 9 hours of expert guidance in ultrasonic rhinoplasty.