title: Sonic rhinoplasty: histologic correlates and technical refinements using the ultrasonic bone aspirator.
abstract: OBJECTIVE
  To demonstrate histologic correlates and 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 academic 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. We performed histologic analysis of cartilage samples, and the patient and surgeon subjectively evaluated the aesthetic outcome of the procedure.
  
  
  RESULTS
  All patients obtained satisfactory outcomes. 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 underresection of the dorsum. No patients experienced skin or soft-tissue injury.
  
  
  CONCLUSIONS
  The ultrasonic bone aspirator can be a useful adjunct for the cosmetic rhinoplasty surgeon. The ultrasonic bone aspirator 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. Complications associated with the device are rare.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. jewel.greywoode@gmail.com
authors.forename: Jewel D
authors.initials: JD
authors.lastname: Greywoode
authors.forename: Edmund A
authors.initials: EA
authors.lastname: Pribitkin
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000601:surgery*; D015508:Nasal Obstruction / Q000601:surgery; D012225:Rhinoplasty / Q000295:instrumentation* / Q000379:methods; D014465:Ultrasonics / Q000295:instrumentation*; D055815:Young Adult