Here's what to expect from an Ultrasonic Rhinoplasty in Dubai, including real before-and-after's, who is eligible, and where to get it done.
28 March 2022| Last updated on 30 March 2022
Ultrasonic Rhinoplasty, also known as Piezo Assisted Rhinoplasty, is a contemporary technique involving ultrasonic energy for bone reshaping during rhinoplasty to remove bumps, narrow nasal bones, and correct asymmetries.
Ultrasonic or Piezo- rhinoplasty avoids the need for a hammer and chisel used in traditional rhinoplasty techniques, thereby allowing greater control and precision. In addition to delivering a more polished look, ultrasonic rhinoplasty reduces soft tissue trauma and, therefore, bruising and swelling after surgery.
Ultrasonic Rhinoplasty is becoming increasingly known in the Middle East. It is certainly one of the most sought-after procedures at Elite Plastic & Cosmetic Surgery Group in Dubai Healthcare City.
The nose plays an essential role in both your facial appearance and breathing function. Rhinoplasty is reshaping of the nose through surgery and thereby achieving better harmony, facial balance and breathing ability. Rhinoplasty is more than just one type of operation; it consists of several techniques which can be employed to reshape various proportional properties of the nose.
Each technique has its advantages and disadvantages and these, along with the wishes of the patient, determine the surgical approach. We believe that subtle changes in anatomy of the nose often make profound differences in appearance, making rhinoplasty one of the most challenging yet elegant procedures in plastic surgery.
At Elite plastic & Cosmetic Surgery Group, the Ultrasonic Rhinoplasty is performed by our Specialist Plastic Surgeon, Dr Shahram, and he was the first Plastic Surgeon to implement the Ultrasonic (or Piezo) technique in his rhinoplasty procedures in UAE. The Ultrasonic (or Piezo) Technique was developed in 2013 and Dr Shahram has been Performing Ultrasonic Rhinoplasties since 2014.
A thorough consultation with an experienced surgeon is a necessary first step, you should be able to discuss your concerns and goals with wanting surgery, and also be fully assessed and be informed of your options, the implications and limitations of surgery and whether or not you are a suitable candidate.
Although nothing can take the place of a one-to-one consultation with an experienced Surgeon, here are 5 things we feel are necessary to know when considering Ultrasonic Rhinoplasty or any other Rhinoplasty Surgery.
Every nose is different and requires a bespoke surgical plan. However, with rhinoplasty in general, alterations can be made to the size of the nose, making it bigger or smaller. The shape of the nose, most commonly the tip or bridge; reduce the size of the nostrils and width of the nose through a technique called alar resection; straighten a crooked nose, caused by a deviated septum or fracture, with a procedure called a septoplasty, or to change the angle between the nose and upper lip.
The open rhinoplasty approach allows for maximum visualisation and extensive soft tissue (like nasal cartilage and nasal skin) changes in addition to the high precision Ultrasonic wave nasal bone contouring.
We strongly believe in creating natural results and rhinoplasty is one of those procedures that minimal changes can achieve significant differences in the appearance. The most important part is the time spent during pre-op consultations, discussing your individual needs and taking the time to get to know you and your goals.
Furthermore, we must emphasise that every nose is different and requires a tailored treatment plan when deciding on appropriate techniques to be used. Also, there are limitations as to what can and cannot be achieved, major radical changes are difficult to achieve safely without complications and compromising the functionality of the nose, beware of the surgeon that suggests otherwise.
Ultrasonic Rhinoplasty – What It Is & How It Works
Traditional rhinoplasty often involves breaking bones, either to remove a hump, or to narrow down the bridge, all of which is achieved using a chisel and hammer. The Ultrasonic Rhinoplasty avoids hammers and chisels, instead it uses high speed sound waves to cut, shape, and polish the hard cartilage and bony structures of the nose.
A piezotome is the specialised instrument used for transmitting the ultrasonic energy to the bone, this device comes with various sculpting tips. These tip inserts allow the surgeon to file, polish, pierce holes, or create breaks in cartilage and bone. The Ultrasonic energy is only absorbed by the bone/hard cartilage hence there is no trauma or damage to the surrounding tissue.
With less surrounding trauma, you decrease the amount of surgical bleeding, post-surgical bruising, swelling and pain from a rhinoplasty procedure while also creating a more accurate cosmetic outcome. This, in turn, should lead to less need for revision surgery.
During an ultrasonic rhinoplasty, an open technique is used for better exposure of the nasal bone.
Both open and closed techniques aim to refine the shape of the nose or alter it to achieve facial balance, however the limited visualisation of the nose structure in closed rhinoplasty, limits the alterations that can be made to the nose.
The open approach provides exposure of the nasal bone structure in its natural position and allows for extensive soft tissue (like nasal cartilage and nasal skin) changes in addition to the high precision Piezo energy nasal bone contouring in Ultrasonic Rhinoplasty.
In terms of incisions in closed and open rhinoplasty, the main difference is that in addition to the internal hidden incisions in closed rhinoplasty, a small v-shaped incision is made at the base of the nose, the columella, during the open approach.
While this places a small scar on the exterior of the nose, if you do not have problems with scarring and with proper technique, this incision and resulting scar heals very well into a faint line and becomes unnoticeable once healed.
The photos below show the location of the columella incision in open rhinoplasty. Two identical photos were taken, Left is before and right is 9 months after. The scar is barely visible, and the healing process is still not complete!
Ultimately it is your decision which approach is implements in your Rhinoplasty, however you should fully understand all the implications involved with each option, including recovery, limitations when it comes to outcome and possible risks and complications.
While many may have their preference for closed or open approach, your surgeon should explain what can or cannot be achieved with either option and discuss the pros and cons with you. Based on thorough assessment of your nose and the goals established by you and your surgeon during your consultation, he or she may recommend the technique that would provide you with the best possible outcome.
Although, some surgeons exclusively perform one technique out of the two, we strongly believe that patients should be made aware of both closed and open approach and the decision should be made based on the specific needs and desires of individual patient.
Another important factor to consider is that an Ultrasonic Rhinoplasty needs to be performed using an open approach and cannot be used with a closed or intranasal approach. This is because the instruments are not long enough, and direct visualisation of the bones is required for the piezo bone sculpting. However, when indicated the advantages of an Ultrasonic Rhinoplasty outweigh the presence of a minimal scar which is unnoticeable if you do not have any scar healing issues.
Rhinoplasty, Traditional or Ultrasonic, can enhance your appearance and self-esteem. However, prior to undergoing any surgery, think carefully about your expectations - they must be realistic.
The goal of rhinoplasty is an improvement, not perfection, in the way you look. The ideal candidate is someone who is physically healthy, psychologically stable, and realistic in his / her expectations.
Get The Most Out of Your Initial Consultation
The most important thing is to consider exactly what it is you want to change or what you are trying to achieve from your surgery. The nose is a very prominent feature of the face, and many patients who come and see us, have been self-conscious about theirs for many years. You should have realistic expectations and look at your face as a whole, when deciding on the changes you want made.
We normally see our patients twice before surgery. During the initial consultation, in addition to discussing your concerns and wishes, we also go through your medical history, including any past nasal injuries or surgeries that you may have had. Then we perform an internal and external examination of your nose, evaluating the structure of your nose and face, assess any breathing problems and discuss the various surgical options with you, including potential risks and limitations.
We also take into account your nasal structure (bone and cartilage), the quality of your skin, the shape of your face, projection of your chin and your age when suggesting a surgical approach, as these factors will influence the procedure and outcome of surgery.
Our advice to you is to be honest and open in discussing your expectations with your surgeon, do not hold back and ask as many questions necessary until you are satisfied that you fully understand all the implications, including limitations, involved with surgery and the options being offered to you.
Recovery after rhinoplasty varies between individuals but generally it is a painless surgery, patients can expect 5-7 days of initial recovery where bruising and swelling may be more noticeable. The nose will also feel congested during the first few days but will gradually improve. The nasal splint comes off between 7-12 days, depending on the extent of surgery and the technique used. Most patients return to work once the splint is removed. Exercise and strenuous activity can be resumed after 4-6 weeks after surgery.
Recovery following a closed rhinoplasty is typically faster than after open rhinoplasty. Nevertheless, in the majority of cases it takes up to 12 months for the swelling of soft tissue to completely subside and sometimes even up to 18 months in the tip area. It is also necessary to be prepared for the fact that redness and some skin discolouration may persist until the healing process is complete
Following an Ultrasonic Rhinoplasty, the recovery is normally faster, however, you'll still have stitches to remove and need to wear a splint for about a week, but once it's removed, you shouldn't have nearly as much swelling as you would with a traditional Rhinoplasty. However, it should be noted that since a number of different structures are altered during the rhinoplasty it can still take approximately 12-18 months to see the final result after healing is complete. Unfortunately, there is no fast track to the final result but certainly there are advantages in the early recovery period and in the precision of the ultrasonic technique which provides benefits in the quality of results obtained.
Many times, taping the nose (mainly at night) will help with keeping the swelling down and preventing internal scar tissue build up. However, it is important to tape your nose correctly as otherwise you may alter the shape, especially during the first few weeks.
Post-operative follow-up appointments after a rhinoplasty are very important in evaluating the healing process, so make sure to keep your appointments at the interval recommended by your surgeon.
Choosing the Right Surgeon in Dubai...
Rhinoplasty can be performed by Plastic surgeons, ENT surgeons and Maxillofacial surgeons. It is important to choose a surgeon with extensive experience in rhinoplasty. We advise our patients to see more than one surgeon before deciding how to proceed. As same result can be achieved through various methods and techniques, and you may find one surgeon’s method suits your lifestyle more than another.
Another aspect to consider is finding a surgeon who you feel comfortable and at ease with. The doctor-patient relationship and open communication is important as you will be seeing each other quite a few times before and after surgery and you will need to feel assured and confidence in the advice and care you receive.