Summary: Rhinoplasty is among the most popular aesthetic plastic surgery procedures, and for good reason. The face can be a delicate balance between the ears, eyes, nose and lips (not to mention eyebrows, frown lines and so on). As the centerpiece of your face, the nose plays an important part in those proportions and has a staggering ability to throw everything off. Therefore, many people elect to pursue rhinoplasty to bring their faces back into order. But because noses are so varied, this is a necessarily complex surgery. And the technology hasn’t always kept up.

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Bones and Cartilage

Believe it or not, there are bones in your nose. I know, I know, we all grow up hearing about your nose is purely cartilage (sharks’ skeletons are mostly cartilage by the way… it may not seem important, but it’s interesting). And it’s true, your nose is mostly cartilage, but there’s still some bone in there. And that’s where rhinoplasty can get a little messy. In order to give you the look you want, your surgeon might need to rely on tools such as power assisted rasps, carbide rasps, or even bone saws. The more tools a surgeon relies on, typically, the less control over the end result your surgeon maintains.

To be sure, these tools are necessary in many cases and still provide excellent results. But a bone saw can lack finesse, if only because a surgeon has to be very, very careful not to inflict any unintended injury on the tissue surrounding bone and cartilage. That’s where a novel use for an old piece of technology might start becoming useful. An ultrasonic bone aspirator essentially uses sound waves to remove bone without causing harm to surrounding tissue. This piece of technology has been around since the 1970s and was originally developed for use in the dental field. Since then, it has been refined and used regularly in neuroscience.

Novel Technique

But this novel technique, using the ultrasonic bone aspirator in the nose, is a great way to ensure that aesthetic plastic surgeons continue to gain more and more control—thus, assurance—over the end results of what can sometimes be a delicate surgery. During most rhinoplasty procedures, a small incision is made at the base of the nose—that little piece of flesh between your nostrils. Your skin is then quite literally pulled up over your nose in order to give surgeons clear access to all the nitty gritty underneath.

During surgery, we’ll be honest, it’s not really a pretty site. But this method has two benefits. First, scarring is kept to a minimum and can only be found in a relatively obscure place. Plastic surgeons figure not many people are going to take a long hard look between your nostrils (and if they do, it’s likely they’ll find objects of interest other than your scar).

By giving plastic surgeons access to much of the inner workings of your nose, it also provides the best chance to address what are ultimately rather unique attributes. Because here’s the thing about the nose: it’s about balance. Rhinoplasty is a procedure that must take into account the overall composition of the face.

The Demands of Rhinoplasty

We can also think about it another way. With a breast augmentation, the size moves in one direction: up. If women want smaller breasts, they opt for a breast reduction, which is an entirely different procedure. And this segmentation of intention is something you’ll see in many aesthetic plastic surgery procedures. Certain procedures go up. Other procedures go down. The same is not true of rhinoplasty.

In fact, rhinoplasty surgeons must be able to increase the size of the nose, decrease the size of the nose or change the general shape of the nose all in the same procedure. According to the website of the Connecticut rhinoplasty experts at Westport Facial Plastic Surgery, many patients have different opinions on what their nose should look like, though there are some common demands. Many patients want a defined bridge—and there are some angles for the bridge that are more popular than others.

The Nose Can Change Everything

The other interesting thing about the nose is that, unlike many other aesthetic plastic surgery procedures, many patients don’t want other people to notice the nose after surgery. Rather, they look at rhinoplasty as a way to get the nose to disappear back into their face—in other words, many rhinoplasty patients feel as though their nose already draws too much attention. Rhinoplasty is a way of escaping that attention.

So, yes, rhinoplasty may be a more complicated procedure than many others, if for no other reason than consistently varied list of demands and desires from patients. On the plus side, rhinoplasty surgeons continue to find innovative uses for old technology, such as the ultrasonic bone aspirator, to make their results better and the surgeries more efficient. I wouldn’t be surprised if you saw this device in the operating room during your rhinoplasty. I’m sure it’ll catch on fast.