Commentary on: Double-Blind Comparison of Ultrasonic and Conventional Osteotomy in Terms of Early Postoperative Edema and Ecchymosis.

Abstract

This interesting article by Ilhan et al compares the degree of postoperative edema and ecchymosis (complications after rhinoplasty) after procedures in which an osteotomy is performed with conventional instruments vs ultrasonic instruments.1 Although most surgeons believe that edema and bruising are typical outcomes after any type of surgery, aesthetic surgeons are always striving to simplify the postoperative course of rhinoplasty. It should be noted that the rhinoplasties in the Ilhan et al study were performed using a dental device that is not approved for use in the operating room (the VarioSurg3 piezosurgery unit, Nakanishi Inc., Kanuma, Tochigi, Japan) as well as maxillofacial inserts that are not designed for rhinoplasty. Moreover, the operations were not performed exclusively with piezoelectric instruments – hump removal was done with a Rubin osteotome and bone rasping was done with a mechanical rasp. The authors state that uncontrolled or comminuted fractures can result from conventional osteotomies and that using conventional instruments for this procedure is more likely to result in bleeding, bruising, and edema. However, in …