Ultrasonic rhinoplasty: a guide to nose surgery

Ultrasonic rhinoplasty is a rhinoplasty in which the bone of the nose is shaped with a piezoelectric instrument, which vibrates at ultrasonic frequency, instead of with a chisel and mallet. Its aim is that of any rhinoplasty: to change the appearance of the nose and, if needed, to help you breathe better. In this Clínica EGOS guide you will find which part of the nose is treated with ultrasound, who it is considered for, how the choice between open and closed surgery is made and how the operation and the postoperative period unfold, so that you go to your first visit knowing what to ask.

The tool changes one part of the work, but the result depends on the study of your face and on the plan made beforehand.

What is ultrasonic rhinoplasty?

The SECPRE describes rhinoplasty as the operation that reshapes the nose and that can at the same time correct congenital defects, the after-effects of injuries and certain breathing problems. Ultrasonic rhinoplasty, also called piezoelectric rhinoplasty, follows that scheme and only the tool used to shape the bone changes: a tip that vibrates at high frequency and cuts hard tissue.

Two clarifications avoid misunderstandings. The first is that ultrasound only works where there is bone; the cartilage of the tip and of the wings of the nose is worked with the usual instruments. The second is that what has been measured so far refers to the first few days: a review of 19 randomised trials with 905 patients (Armanfar and colleagues, 2026) found less swelling, less bruising and less pain with ultrasound during the first few days, but did not measure whether the nose ends up more harmonious. Another meta-analysis, from 2019 (Kim and colleagues), found that the advantage disappears when the chisel cuts are made with the bone in view.

Who is ultrasonic rhinoplasty considered for?

The ASPS insists that the decision is your own: you have surgery for yourself, not to please someone else or to look like somebody else’s model. The profile it describes is that of a person whose facial growth has finished, who is in good health, does not smoke and has realistic goals. The SECPRE adds that the aim is an improvement, not perfection, and that the operation will not make us look like someone else.

It is not a single-sex surgery: Cleveland Clinic notes that almost one in five rhinoplasty patients in the United States is a man, and a 2025 review of satisfaction after the operation did not find sex to be a decisive factor. Before setting a date, the ASPS asks you to stop smoking; everything else you discuss with the surgeon at the consultation.

The first consultation: what is examined and what is decided

At the first visit a plastic surgeon talks with you. According to Cleveland Clinic, they examine and measure your face, take photographs and discuss the options and the results that can be expected; the ASPS adds that they will want to know your medical history, the medicines and supplements you take and whether you smoke. If you have them, bring photos of your nose from before an injury.

Photos of noses you like help to explain what you are looking for, not as a mould. At that visit it is decided what is changed and what is not, whether the operation will be open or closed, which part will be done with ultrasound, whether the septum needs to be touched or cartilage added and under which anaesthesia it will be done. It is best to bring your questions about the plan, the anaesthesia, the timescales and the check-ups written down.

Open or closed rhinoplasty: how the choice is made

In closed rhinoplasty, the surgeon works through incisions inside the nostrils, without cutting the outer skin. In open rhinoplasty a small incision is added across the columella (the bridge of tissue that joins the tip to the base), and the skin is lifted until the whole structure is in view. How the columella heals depends on each person. The NHS points out that the closed approach is not always possible.

Which gives a better result? A systematic review with meta-analysis published in 2025 (Abi Zeid Daou and colleagues) compared the two approaches in twenty studies, twelve of them with data that could be pooled, involving 1,067 patients. It found no significant differences in satisfaction, breathing improvement, swelling, bruising or operating time, although the quality of the studies was moderate. Its authors conclude that the choice should be tailored to the patient’s needs and the surgeon’s experience. In other words: the approach is chosen according to what needs correcting, and the open one is not the good one nor the closed one the limited one.

What the ultrasonic rhinoplasty operation is like

Rhinoplasty is always done in an operating theatre, in a clinic or hospital. At Clínica EGOS it is performed under general anaesthesia.

The steps, according to the ASPS, are these. After the anaesthesia the incisions are made, closed or open, and the skin covering the bones and cartilage is lifted. The framework is then reshaped: this is where the ultrasonic instrument comes in on the bone, the cartilage is reduced or repositioned and, if needed, grafts are added, almost always from the septum itself and, more rarely, from the ear or a rib. If the septum is deviated, it is straightened. Finally the skin is repositioned and the incisions are closed, and sometimes small incisions are made in the folds of the nostrils to change their size.

At the end a splint is placed over the bridge of the nose and, depending on the case, nasal packing. The ASPS advises arranging in advance who will take you home and stay close to you the first night; your surgeon will tell you when you will be discharged.

Recovery from ultrasonic rhinoplasty: Clínica EGOS timescales

The splint is removed after five to seven days, and most patients return to their normal life within seven to ten days. For the first few nights you sleep on your back with your head raised. Strenuous exertion waits at least fifteen days, and glasses resting on the bridge of the nose, four to six weeks; if you need them, use a light pair supported on the forehead.

For eight weeks, according to the SECPRE, the nose should not be exposed to direct sun or knocks. What each week is like, with its care, we explain in the guide to recovery from rhinoplasty, and what you notice with the splint on and when it comes off, in the article on the nose splint.

When is the result of ultrasonic rhinoplasty fully visible?

The final result is seen between six and twelve months; until then, the nose keeps changing from one week to the next. On the satisfaction of those who have the operation, a 2025 meta-analysis (Alotaibi and colleagues) that brought together twenty-four studies using the ROE questionnaire found a significant improvement in satisfaction and quality of life after the operation, with very high variability between studies. These are average figures for groups of patients, which do not anticipate what you will notice. The ASPS adds that the result lasts, although over the years the nose changes as the rest of the face does, and sun protection helps to maintain it.

Rhinoplasty and breathing

Rhinoplasty can go beyond aesthetics. The ASPS notes that it also corrects breathing problems caused by structural defects. A 2017 meta-analysis of sixteen studies (Floyd and colleagues) showed that functional nasal surgery reduced the nasal obstruction score by 43 to 50 points out of 100 between 3 months and one year, with considerable variability between studies; another review from 2024 (Chen and Zhou), with 971 patients, also found an improvement in quality of life. If you have a deviated septum, surgery on it can be done in the same operation, and how the septum is repaired is explained in the article on nasal septum reconstruction.

A previously operated nose and temporary alternatives

Secondary rhinoplasty is the one performed on a nose that has already been operated on, to correct some aspect that has not turned out as expected. Cleveland Clinic describes it as more complex than the first operation. If you have had a previous operation, bring the operation report or the photos from before.

Non-surgical rhinoplasty is an aesthetic medicine treatment, with a temporary effect, that fills small irregularities. According to Cleveland Clinic, it can lift the tip slightly or disguise a small hump; it does not alter the bone or correct a breathing problem.

What should the quote for ultrasonic rhinoplasty include?

We do not set amounts without having examined you: the cost of a rhinoplasty comes from what needs to be done to your nose, that is, the open or closed approach, the grafts, any work on the septum, the type of anaesthesia and the hours in theatre. After examining you, we give you the quote in writing.

Ask for it to list fees, theatre, anaesthesia, materials and check-ups; and, if you are comparing two clinics, for both quotes to cover the same things.

Who operates and where?

The operations are carried out by registered plastic surgeons at Clínica EGOS, including Dr Santiago Elvira i Barberà (registration no. 49756) and Dr Tiago Gomes Rodrígues (registration no. 44844). Before setting a date, ask to be told in writing who will operate on you, with their medical registration number, and at which centre.

The cities with their own ultrasonic rhinoplasty page are listed in the “Where to have ultrasonic rhinoplasty?” section further down.