What Is an Ultrasonic Rhinoplasty? A Doctor Explains

Plastic surgery is constantly evolving., Now, cutting-edge, precise techniques minimize bruising and lead to quicker recovery times so you can rejoin life as fast as possible. Traditional procedures that once required you to hibernate for weeks at a time now require a few days of downtime. One particular plastic surgery procedure that is changing the face, pun intended, of plastic surgery is rhinoplasty, aka a nose job.

Augmenting the nasal bone and cartilage has never been more popular — the American Society of Plastic Surgeons reports a 6 percent increase in rhinoplasty procedures in 2023. One rhinoplasty technique in particular is growing in popularity — the Piezo Ultrasonic Rhinoplasty. Below, learn more about this innovative technique that cuts down recovery time and leaves patients with precisely sculpted noses.

Experts Featured in This Article

Sam Rizk, MD, FACS, a double-board certified facial plastic surgeon in New York City who specializes in the piezo technique.

What Is a Piezo Ultrasonic Rhinoplasty?

Before we delve into the nuances of the Piezo Ultrasonic Rhinoplasty, or the “baby rhinoplasty, as some call it, it’s important to understand the intent of rhinoplasty. No matter the technique, it’s intended to reshape the cartilage and bone to make the nose smaller and/or more symmetrical to the features of the face. Traditionally rhinoplasty uses surgical chisels, rasps, and hammers to reshape the nasal bones, which induces significant injury to the nose and subsequently the face — this is why you tend to see a significant amount of bruising in the surrounding area. The Piezo Ultrasonic Rhinoplasty technique approaches rhinoplasty in a much more precise and less traumatic manner.

Introduced in 2004 by Massimo Robiony, who is a maxillofacial surgeon, the technique employs a device called a piezo. “While traditional rhinoplasty relies on manual instruments like rasps and knives, the piezo technique utilities ultrasonic vibrations controlled by the surgeon through a touchscreen and foot pedal for smoother and more controlled bone restructuring,” Sam Rizk, MD, FACS, a double-board certified facial plastic surgeon in New York City who specializes in the piezo technique, tells PS. It’s particularly beneficial when the patient requires reshaping of “hard structures like bone, rather than addressing soft tissue change,” he adds.

The tool itself, which is called a piezotome, uses high-speed sound waves to reshape the nose. “It works by transmitting ultrasonic energy to the nasal bones through tiny cutting and shaving tip inserts that precisely shave, smooth, and reduce the bones,” says Dr. Rizk. The ultrasonic vibrations emitted from the device are so gentle, compared with the tools used in traditional rhinoplasty, that the “trauma is minimal, the risk of damage and bone resorption is almost non-existent, and recovery time is unparalleled,” he says.

Piezo Ultrasonic Rhinoplasty vs. Traditional Rhinoplasty

Though we’ve already touched on the differences between the Piezo Ultrasonic Nose Job and the traditional rhinoplasty — the largest difference being the instruments used — they generally fall under two different types: open and closed rhinoplasty. The Piezo Ultrasonic Rhinoplasty can only be used during open rhinoplasty and traditional rhinoplasty can be either open or closed.

Closed rhinoplasty, says Dr. Rizk, involves incisions inside the nostrils, with no external incisions or visible scars. “It provides direct access to the nasal framework while minimizing scarring and maintaining the nose’s natural shape, but it offers limited visibility and control during the procedure.” In other words, closed rhinoplasty is used for a minimal or less complicated change to the nasal structure.

“Open rhinoplasty involves a small incision between the nostrils, called the columella, and additional incisions inside the nose. The skin on the nose is folded up to allow the surgeon to see the nasal structures directly and reshape the inside of the nose. This approach is often used for extensive reshaping or revision rhinoplasty cases,” says Dr. Rizk. Because the nasal structures need to be visible to reshape the nose, the piezo technique can only be used during an open rhinoplasty. The instruments used during the Piezo Ultrasonic Rhinoplasty are not long enough to be used while closed because “direct visualization of the bones is required for the piezo bone sculpting.” Despite ending up with a small scar that’s virtually undetectable, the advantages of the piezo technique outweigh the presence of a scar.

Who Is a Good Candidate For the Piezo Ultrasonic Nose Job?

Dr. Rizk says that a good candidate for the Piezo Ultrasonic Rhinoplasty is someone who requires a reduction or adjustment to the nasal bones, “including a bony hump reduction, adjustment of bony deviations or bone irregularities, and narrowing the bony mid vault.” Patients who are seeking nasal tip or cartilage adjustments won’t benefit from the piezo technique, where suture and grafting techniques are used instead.

How Much Does the Piezo Ultrasonic Rhinoplasty Cost?

The cost of the Piezo Ultrasonic Rhinoplasty depends upon geographical location, complexity of the rhinoplasty, and the plastic surgeon’s level of experience. Though the cost can vary from $5,000 to $15,000, for Dr. Rizk’s level of expertise with the technique, expect to pay anywhere between $40,000 to $50,000.

Piezo Ultrasonic Rhinoplasty Aftercare

After surgery, patients can expect to see closed incisions and to be wearing a splint for a week post-surgery to support the nose. Patients will also likely experience some swelling, bruising, and slight discomfort, which Dr. Rizk says typically subsides within a week. “[I]t’s important for patients to remember that it can take approximately a year to see the final result,” Dr. Rizk says.

Ultimately, making an informed decision about whether an ultrasonic nose job is for you should be made with the help of a trained doctor. “Patients should be careful to select a board-certified facial plastic surgeon who is proficient in the piezo technique and fully understands not only its benefits but also its limitations,” says Dr. Rizk.

Taryn Brooke is a beauty writer and editor born and bred in New York City who has been in digital media for over 10 years. She is a contributing beauty writer for PS, Allure, Byrdie, and Well+Good.