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
"Yes....I have had quite a battle with the appearance of my nose. I was bit by a dog at the age of 2. This injury damaged me to where my nose never grew a bridge and my nostrils were uneven. I discovered Dr. Shah through a google search, scheduled an appointment, and from my first few minutes in his office I felt that I was in the right place. Not only is his staff polite, kind and attentive, Dr. Shah has a very calm and happy....yet focused personality. He saw the imperfections, that I saw and gave an extremely detailed lay out of what could be done to improve the appearance of this nose that had undermined my self esteem, for so long. Obviously, Dr. Shah is an expert, and if you were to see my before and after photos, you may even call him a magician. However, the things that up him over the top, for me, is that....Every moment with Dr. Shah and his staff, from my initial consultation to pre op, post op, bedside calls and follow up appointments have been nothing less than top notch, 5 Star patient care."- T.R. / Google / Aug 26, 2018
"Passing Happiness on to Others - Yes....I have had quite a battle with the appearance of my nose. I was bit by a dog at the age of 2. This injury damaged me to where my nose never grew a bridge and my nostrils were uneven. I discovered Dr. Shah through a google search, scheduled an appointment, and from my first few minutes in his office I felt that I was in the right place. Not only is his staff polite, kind and attentive,..."- T. / RealSelf / Aug 20, 2018
"Dr. Shah is THE surgeon to go to - Wonderful, friendly, and a Master of his specialty. Just by speaking with him, you are aware of his expertise and professionalism. He truly cares about his patients' concerns and happiness. I couldn't have asked for a better experience, both in his office and through surgery. Not only is Dr. Shah great, but the Office Staff is warm and welcoming. Dr. Shah has helped me feel like a true woman for the first time in my life. After becoming very ill at an adolescent age, and dealing with a 105+ lbs weight gain and 80+ lbs weight loss, my skin had been stretched, my breasts were sagging, and my thighs had been affected. Needless to say, I was very, very self conscious. Being in my 20's, I wanted to enjoy feeling how a normal 20-something-year-old should feel, especially after my medical cure. Dr. Shah helped my husband and I choose the right size breast implants for my body-type and activity level and walked us through every option and how each procedure would go. I underwent surgery and had breast augmentation and thigh liposuction. Surgery and recovery went exceptionally well. Three months out and I continue to be happier and happier as each day goes by. The results are even better than I expected. Dr. Shah made my dreams come true. I continue to see him to further work on other things I wish to fix. I trust him completely and highly recommend him to anyone and everyone."- E.J. / Google / Jul 26, 2018
"Dr. Shah is THE Surgeon to Go to - Wonderful, Friendly, and a Master of His Specialty. - Dr. Shah is THE surgeon to go to - Wonderful, friendly, and a Master of his specialty. Just by speaking with him, you are aware of his expertise and professionalism. He truly cares about his patients' concerns and happiness. I couldn't have asked for a better experience, both in his office and through surgery. Not only is Dr. Shah great, but the Office Staff is warm and welcoming. Dr. Shah..."- E. / RealSelf / Jul 25, 2018
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.