Rhinoplasty with Ultrasonic Piezo: Osteotomy, Bruising, and Returning to Work
Rhinoplasty is one of the most frequently performed aesthetic surgeries worldwide. With advances in technology, patients’ expectations for the postoperative period have also increased. During rhinoplasty consultations, two of the most common questions are: “Will I have bruising?” and “When can I return to work?”
One of the key steps that influences both of these issues is the “osteotomy” stage, during which the nasal bones are reshaped. In conventional methods, bone is cut or repositioned using instruments such as an osteotome and mallet, or by controlled fracturing. During this process, small vessels in the surrounding tissues may be affected, which can contribute to postoperative swelling and bruising.
Osteotomy is the reshaping of the bony structures that form the upper one-third of the nose. Bone contouring can be performed by cutting, fracturing/repositioning, or rasping. In conventional osteotomies, even though the target is bone, the surrounding soft tissues and vascular structures may also be affected. As a result, blood that leaks into the tissues can be seen as bruising (ecchymosis) and swelling (edema), especially around the eyes.
Ultrasonic piezo is a surgical device that helps shape bone with micro‑vibrations and millimetric precision. The main advantage of this system is that it can work more selectively on mineralized tissue (bone) while better preserving the surrounding soft tissues. For this reason, bone reshaping during rhinoplasty can be performed in a more controlled manner.
Ultrasonic piezo is less a “technique” and more a tool/technology used by the surgeon. The aim is to make the osteotomy step more controlled in order to:
Clinical studies have reported that rhinoplasty cases using piezoelectric osteotomy may have lower early edema and ecchymosis compared with conventional osteotomy. However, outcomes can vary depending on nasal anatomy, skin thickness, the maneuvers performed, and individual healing characteristics.
Ultrasonic piezo may be advantageous especially in noses where bony reshaping is a major component. However, the same level of necessity does not apply to every patient. The most appropriate approach is evaluated based on examination findings, nasal bone structure, the presence of deviation, history of prior surgery, and the intended changes.
Recovery after rhinoplasty differs from person to person. Although ultrasonic piezo aims to reduce trauma during the bony phase, it cannot guarantee that swelling and bruising will be completely “zero.” In most patients, the goal is faster early recovery and a more comfortable postoperative course.
Although many studies report that early bruising/swelling may be reduced, it can vary from person to person. The goal is to decrease bruising and make recovery more comfortable; it is not appropriate to promise “no bruising at all.”
No. Ultrasonic piezo is a device used for bone shaping. Whether the surgery is performed with an open or closed approach is determined separately based on your nasal structure and the surgical plan.
Some studies report less early edema/ecchymosis. However, the final shape still settles over months; nasal tip and skin characteristics influence this timeline.
My personal answer is: yes—because ultrasonic piezo allows nasal bone cutting and shaping to be performed in a much more controlled manner, which is one of the most important factors affecting the outcome. The best decision is made after an in‑person examination.
Rhinoplasty service page: https://timurbatmaz.com.tr/en/our-services/rhinoplasty
Contact: https://timurbatmaz.com.tr/iletisim
https://www.instagram.com/op.dr.timur_batmaz/
Information Note: This content is for general informational purposes only and does not replace medical diagnosis or treatment. A personalized plan requires a clinical examination.
