In traditional rhinoplasty, surgical instruments known as rasps and osteotomes (hammer and chisel) are used to reshape the nasal bones by removing the hump and/or narrowing the nasal bone width. These tools are relatively imprecise and their use can lead to contour irregularities, etc. if not used in the proper manner. Powered devices have been developed that can save time, and these devices have improved on the inaccuracies of the manual tools, but they still have some of the same complications involving contour and shape. Recently, a technology that uses sound waves has been developed to contour nasal bones in a precise and far less traumatic way when compared to traditional techniques. Ultrasonic, or Piezo, rhinoplasty is now the most advanced technique available for minimally traumatic nasal bone reshaping and hump removal during rhinoplasty. This technology is currently only available in CA, NY, FL, and at Shah Aesthetic Surgery in Denver. Dr. Shah is a well-regarded rhinoplasty specialist in Denver, Colorado and he has been using ultrasound technology in cosmetic surgery since 2005. Dr. Shah utilizes the Comeg Medical Piezotome(R) M+ ultrasonic rhinoplasty device. It is the only device FDA approved solely for rhinoplasty. Dr. Shah uses the Expert Rhinoplasty Tip set designed by Dr. Olivier Gerbault.
The technique for ultrasonic rhinoplasty is a bit different from that of traditional rhinoplasty surgery. The skin undermining over the nasal bones is more extensive to expose all the bony surface area. The entirety of the nasal bone architecture can be seen. The ultrasound wand can be equipped with different tips that can remove the hump, make precise bone cuts that don’t damage the underlying mucosa, and polish any rough surfaces to create a precisely shape nasal bridge. The end result is a more beautiful nose with far less trauma, less swelling, and almost no bruising.
Summary of the Advantages of Ultrasonic Bone Formation:
• It reduces soft tissue trauma to zero. So bruising and swelling is almost nonexistent.
• Owing to controlled cuts, the formed lines appear as if sculpted.
• Providing more elegant transition from nasal bridge to nasal tip.
• It prevents uncontrolled bone fractures due to use of hammer and osteotome methods or micro-motor rhinoplasty instrumentation. Thus, it prevents step-off deformities and contour irregularities.
• Postoperative recovery is faster because it does not cause damage to the soft tissue surrounding the blood vessels and cartilages, so patients may return to their daily lives more quickly. Postoperative pain is typically less as well.
• The accuracy of reshaping the nasal bones is enhanced leading to increased patient satisfaction.
• Complication rates and the need for revision surgery is reduced after rhinoplasty.
"My Muscle Wall Gave Way Giving my Abdomen an Unsightly Large Buldge - Denver, CO - I met Dr Shah in 2007 when he did a face lift for me. I was really happy with the results. When I found out no amount of diet and exercise would remedy the problem with my abdomen I contacted him. and even through I no longer live in Colorado, I knew he was the doctor I wanted to perform my surgery.I am a little over four weeks after surgery and I am thrilled with the results. I am 66 years old and healing well and now I have the tummy I have dreamed of having.Thank you Dr Shah I appreciate your skill and care!"- D. / RealSelf / Sep 05, 2015
"I had been contemplating a revision rhinoplasty after not being fully happy with my first rhinoplasty. I went to several doctors and all told me to put fillers into my nose. I wasn’t comfortable with that as I wanted a permanent fix. I had a few issues with my nose and overall I felt the nose just didn’t fit my face. After talking with Dr Shah I finally felt like I was being heard! I am now 6 or so weeks post revision and I can say all the “problem areas” I was concerned about were corrected. The results are far beyond my expectations! I am also a little bit of a worrier and I’m concerned about persistent swelling occurring again. Even though my follow up is several weeks away, he fit me in sooner to hear my concerns. Having a Dr willing to see you when you feel concerned or worried is worth everything! So not am I only over the moon with my results, I feel as though I can come to him with concerns along the way and he will listen. I would highly recommend Dr Shah to anyone considering rhinoplasty or revision rhinoplasty. He is truly and artist and did a wonderful job creating a nose that fits my long, angled face! I am So thankful and so happy!!! Thank you Shah team!!!"- M.N. / Google / Jul 25, 2019
"I went to MANY surgeons for rhino/septoplasty consults before finding Dr. Shah. The second I met him I knew he was the surgeon I wanted to perform the rhinoplasty. He is compassionate and thoughtful in his approach and explains the procedure very thoroughly. He wants the patient to be educated in his reasoning for what he does and make sure everyone is on the same page. He was one of the only surgeons that I felt truly took the time to understand what I wanted in a final outcome, as well as being very realistic with the results and making sure my breathing was optimal after surgery. I was able to see what the final outcome would be, and he was great at tweaking things to fit what I was wanting. He answered every single question I had pre AND post-op, (and was available for any questions I had while recovering, which most surgeons don't do). It has now been one month post-op, and I could not be more thrilled with my nose. Although I am only one month out, my nose is already everything I wanted and so much more, and my breathing is better than ever. Dr. Shah is truly a miracle worker. I cannot wait to see how it continues to change throughout the next eleven months. Dr. Shah represents the very genuine and sincere side of healthcare that is so rare to find nowadays."- L.U. / Google / Jul 17, 2019
"Dr. Shah and his entire staff are absolutley amazing! Everyone at Shah Aesthetic Surgery is extremely sweet and very knowledgeable, it brings a sense of comfort while going through each and every step with them. I wanted a rhinoplasty for years, it was something I thought about every time I looked in the mirror. After breaking my nose playing sports years ago and disliking it even more, I finally scheduled a consultation with Dr. Shah and knew about 30 minutes in that he was the surgeon for me. Dr. Shah sat down with me, anwsered every single question, went over every option available, explained to me in detail everything that would be done, (I didn't know I had a deviated septum as well) and was able to show me what the outcome would look like on me with computer software. I am so incredibly happy with the outcome, my only regret is not finding Dr. Shah sooner! I can't thank the entire team at Shah Aesthetic enough for everything they have done for me, especially helping me gain the confidence I have alway struggled with!"- M.K. / Google / Jul 14, 2019
"I am so happy I chose Dr. Shah for my rhino/septoplasty. He is compassionate and thoughtful in his approach and explains the procedure very thoroughly. He wants the patient to be educated in his reasoning for what he does and make sure everyone is on the same page. He took the time to understand what I wanted in a final outcome, as well as being very realistic with the results and making sure my breathing was optimal after surgery. He answered every question I had pre and post-op, (and was available for any questions I had while recovering, which is rare to find). It has been one month post-op, and I could not be more thrilled with my nose. Although I am only one month out, my nose is already everything I wanted and so much more, and my breathing is better than ever. Dr. Shah is truly a miracle worker. I cannot wait to see how it continues to change throughout the next eleven months. Dr. Shah represents the very genuine and sincere side of healthcare that is so rare to find nowadays"- L. / Healthgrades / Jun 26, 2019
This blog gives you all the information you might want about the most difficult procedure in cosmetic surgery, written by Manish H. Shah, MD, FACS, a specialist in rhinoplasty, revision rhinoplasty, and ethnic rhinoplasty surgery located in Denver, Colorado.View Blog
Because of the more extensive skin undermining needed to perform ultrasonic rhinoplasty, the surgery itself takes 2-3 hours to perform. Recovery after ultrasonic rhinoplasty is similar to traditional rhinoplasty. You still need to wear a nasal splint for seven days. You still need to sleep with your head of bed elevated, and you still need to apply ice to the nose. Dr. Shah still uses night time taping and soft tissue massage techniques after the splint is removed at postoperative day number seven. The difference is that your nose looks more presentable to the public early on and the long-term final result is enhanced once full healing has occurred at the one year postoperative mark.
Am I a candidate?
Yes, anyone who is healthy enough for traditional rhinoplasty is a candidate for ultrasonic rhinoplasty. The investment in this procedure is offset by the reduced need for revision surgery in the future.
How does ultrasound work?
Ultrasonic devices use high speed sound waves to create vibrations in tissue. These vibrations cause gentle breaking apart of tissue surfaces to remove surface irregularities and cut tissues, all while avoiding damage to underlying structures. In other words, it treats the areas that need treatment in a highly targeted and precise way, all while keeping damage to a minimum.