Ultrasonic rhinoplasty: sub-millimeter precision in bone.
Piezoelectric instruments replace the hammer and chisel with a tool that vibrates at ultrasonic frequency and cuts only bone. Skin, mucosa, vessels and nerves are spared.
Ultrasonic rhinoplasty is rhinoplasty in which the nasal bones are cut and sculpted with a piezoelectric device that vibrates at ultrasonic frequency and acts only on bone. Because it does not injure skin, mucosa or vessels, it produces less bleeding, less bruising and less swelling, and allows more precise, predictable osteotomies than a chisel. Dr. Guilherme Sella uses piezo routinely and teaches it in the Preservation Ultrasonic Rhinoplasty Course.
How piezo works
The device converts electrical energy into high-frequency mechanical vibration. Fine saws and rasps cut and smooth bone but stop at soft tissue. In practice the surgeon can:
- Perform osteotomies under direct vision, with clean lines and no irregular fractures
- Rasp the hump millimeter by millimeter instead of removing it en bloc
- Refine bony asymmetries with fine control
Conventional vs. ultrasonic
| Chisel and hammer | Piezoelectric |
|---|---|
| "Blind" fractures, risk of irregular lines | Precise cuts under direct vision |
| Soft-tissue and vessel trauma | Acts on bone only; vessels and mucosa spared |
| More periorbital bruising and swelling | Less bruising, shorter swelling |
| Less predictable bone result | Greater predictability and symmetry |
Who benefits
Virtually every nose that needs bone work: humps, wide dorsums, bony deviations, post-fracture deformities and revisions with bony asymmetry. In thin-skinned noses the benefit is even greater, because bony irregularities become visible.
Piezo and preservation
Ultrasound found its best use in preservation rhinoplasty. Precise bone cuts make it possible to lower the dorsum as a single unit without opening the roof. This combination, Preservation Ultrasonic Rhinoplasty, is what Dr. Sella practices routinely and teaches in live-surgery courses.
Recovery
Most patients show little or no bruising around the eyes. The external cast is removed at about 7 days, and light activities resume in 10 to 14 days.
Otolaryngologist and facial plastic surgeon · CRM-PR 33.018 · RQE 17.984. PhD from FMRP-USP, founder of the Sella Learning Center. Updated on 2026-10-07.
Frequently asked questions
Is ultrasonic rhinoplasty less painful?
Pain is already rare in rhinoplasty with any technique. What piezo clearly reduces is bruising and swelling, because it does not injure the soft tissue around the bone.
Is every piezo rhinoplasty an open rhinoplasty?
Not necessarily. Piezo requires good bone exposure, usually achieved through the open approach, but reduced-access techniques exist. Dr. Sella defines the approach in consultation.
Book a consultation with Dr. Guilherme Sella
In-person in Maringá, Brazil, or by video consultation. The team speaks English, Spanish and Portuguese.