Modern Rhinoplasty Techniques – Piezo, Preservation, and Structural Approaches
Discover current rhinoplasty techniques: Piezo/ultrasonic rhinoplasty, preservation rhinoplasty, structural approaches, and graft usage. Expert surgical methods for natural, safe, and lasting results.
Modern Rhinoplasty Concepts
Modern rhinoplasty has transformed nose aesthetics from a simple appearance change into both a cosmetic and functional surgery.
Today's goals:
Natural results
Strong structure (supportive structure)
Healthy breathing
Long-lasting nose architecture
Therefore, current surgical approaches combine preservation, structural, ultrasonic/piezo, and graft-supported techniques.
Piezo / Ultrasonic Rhinoplasty
Piezo technology uses ultrasonic waves on bones to make micrometric cuts without damaging surrounding tissues.
Advantages
- Does not damage soft tissues, blood vessels, or cartilage
- Less bruising and swelling
- More controlled bone shaping
- Millimetric natural lines
Who Is It Suitable For?
- Deviation corrections
- Wide nasal bridge
- Patients requiring delicate bone work
Preservation Rhinoplasty (Pushdown & Letdown)
Preservation rhinoplasty is a modern approach that preserves the natural anatomy of the nasal dorsum as much as possible.
Advantages
- Most natural profile
- Less edema
- Less trauma
- Anatomical integrity is preserved
Methods
- Pushdown: Dorsum is lowered as a block
- Letdown: Dorsum is lowered by controlled removal from the lateral bone walls
Structural Rhinoplasty
It is the safest and most permanent method today.
Goals:
- Strengthen the septum
- Support the nasal tip
- Strengthen the airway
- Make the nose architecture stable for life
Techniques Used
- Septal extension graft
- Spreader grafts
- Tip support sutures
- Alar support
Graft Types (Autograft – Allograft – Rib – Ear)
Graft usage plays a critical role in modern rhinoplasty.
Autograft (Your own cartilage)
The safest option. Septal cartilage is the first choice.
Rib Cartilage
Used in revisions requiring major support and deviation corrections.
Ear Cartilage
Ideal for tip shaping and soft contour supports.
Allograft (Cadaver cartilage)
Safe with modern sterilization techniques. Used in revision patients, cartilage deficiency, and cases requiring additional support.
Advanced Surgical Techniques
Advanced surgical techniques used in modern rhinoplasty.
Alar base surgery
Tip refinement sutures
Spreader grafts, flaps
Dorsal hump removal (Ultrasonic or structural)
Tip Refinement (Nasal Tip Shaping Techniques)
The nasal tip is shaped naturally, prominent but not exaggerated.
Lateral crural steal
Tip rotation sutures
Tip projection sutures
Soft tissue modulation
Alar Base Surgery (Nostril Narrowing)
Applied when the nasal wings are wide.
Alar wedge excision
Weir excision techniques
Result: Narrower, symmetrical nasal wings.
Revision Rhinoplasty Techniques
Revision rhinoplasty is performed with a more sophisticated approach.
May require:
- Rib graft
- Allograft
- Septal reconstruction
- Dorsal reconstruction
Revisions generally aim to:
- Correct deformities
- Solve breathing problems
- Correct asymmetries
- Fix collapse issues
Male vs Female Rhinoplasty Approach
Male and female nose aesthetic approaches differ.
In Men
A flatter dorsum is preferred, aiming for a more masculine profile.
In Women
A slightly concave profile is preferred, aiming for a more feminine appearance.
Ethnic Rhinoplasty Approach
Each face has different anatomy.
In ethnic rhinoplasty, the goal is:
Natural ethnic character is preserved
Special techniques for thick skin
Strong graft supports
Preservation of breathing function
Open vs Closed Rhinoplasty
Open Technique
Small incision over the columella. More visible and precise work. Preferred in complex cases.
Closed Technique
Incision is inside. Faster healing. Ideal for patients with suitable anatomy.
Frequently Asked Questions – Technique Specific
Related Topics
Learn more about rhinoplasty
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