Descripción:
Objective: Demonstration of histologic correlates and to describe refinements in cosmetic rhinoplasty using the ultrasonic bone aspirator. Methods: This retrospective review of 103 consecutive patients undergoing cosmetic rhinoplasty at a tertiary care facial plastic surgery practice extends the applications for the ultrasonic bone aspirator to include reducing the nasal spine, glabellar deepening, sculpting of mobile bone fragments after osteotomy, smoothing of bony edges after medial osteotomy, and reducing the convexity of nasal bones. The authors performed histologic analysis of cartilage samples, and the patient and surgeon subjectively evaluated the aesthetic outcome of the procedure. Results: Satisfactory results were obtained in all cases. Seven patients experienced minor complications. One patient had a visible dorsal irregularity, 2 had palpable but not visible dorsal irregularities, 2 had asymmetry of the dorsum, and 2 had under-resection of the dorsum. Skin or soft-tissue injury, was not seen in any case. Conclusions: Ultrasonic bone aspirator can be a useful adjunct for the cosmetic rhinoplasty surgeon. It permits precise, graded removal of bone without damage to surrounding soft tissue or mucosa. With multiple applications in nasal surgery, the ultrasonic bone aspirator permits refinement of subtle irregularities and asymmetry of the nasal bones. Device associated complications are rare.
