Ilhan AE, Cengiz B, Caypinar Eser B. Double-Blind Comparison of Ultrasonic and Conventional Osteotomy in Terms of Early Postoperative Edema and Ecchymosis. Aesthet Surg J. 2016 Apr;36(4):390-401. doi: 10.1093/asj/sjv260. Epub 2016 Jan 22. PMID: 26801234.
Dear all, I'ld like to share this article from a very good surgeon who worked quite early with the piezo instruments I've been working on few years before. Interstingly, it's a double blind study, but I didn't have the same outcomes as him, especially for swelling that was usually more significant the following weeks after surgery than the "usual" rhino. Let's emphasis that we had the same full open approach for the use of PEI. I'd like to have your thoughts.
Olivier Gerbault
Excelent paper Olivier and Emre. Level 3, well designed study. Congrats for the effort! My personal experience with sharp osteotomes+ subperiosteal infiltration + tranexamic + subperiostial tunel confection is almost zero equimoses/swelling in regular primaries. Only a personal opinion.
Miguel Ferreira
Thanks for your answer Miguel. One of the significant issues in rhinoplasty is to quantify the swelling. For the ecchymosis, it's easier. We have to first assess accurately the post op swelling, to look at all the parameters (medical and surgical) that may affect this swelling, and only then can we compare different techniques. Once again, I don't have the same straightforward recovery with some of my patients (not all), who have usually little ecchymosis, but frequently more swelling than what I used to have when I was not using PEI through a full open approach. I try lots of things to decrease the swelling during and after the surgery. But there are lots of things that both of us are doing differently in our procedures. One of them for instance is the location of our osteotomies. It would be intersting to list all the factors that may have an impact on the swelling after a rhinoplasty. Is someone aware about an article on this topic? Thanks
Olivier Gerbault