{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:13:40Z","timestamp":1787008420569,"version":"build-2736575974"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preservation rhinoplasty, particularly dorsal preservation, has gained prominence with the advent of piezoelectric instruments, which minimize trauma and enhance precision in bone reshaping. This approach presents unique challenges, especially in closed techniques, where spatial limitations complicate the use of piezotomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate outcomes of piezo-assisted preservation rhinoplasty performed with specialized instrumentation to enhance visibility, precision, and postoperative recovery in closed rhinoplasty procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a cohort of 734 patients undergoing primary rhinoplasty between May 2021 and April 2023, piezoelectric instruments facilitated closed preservation techniques. Cases were documented with a focus on instrument adaptation, bone reshaping precision, and the mitigation of postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A 6% revision rate was observed, predominantly for dorsal contour adjustments, with minimal intraoperative bleeding, swelling, and postoperative pain, demonstrating the effectiveness of piezoelectric assistance. Woodpecker (Guilin, China) SS18 and SS4 inserts were specifically optimized to enhance cutting efficiency for removal of the perpendicular plate of the ethmoid, and for lateral and transverse osteotomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Piezo-assisted rhinoplasty improves precision and reduces trauma, supporting advanced closed preservation rhinoplasty techniques. Although all osteotomies can now be performed with ultrasonic piezotomes, enhanced instrument design may further refine outcomes, facilitating minimally invasive, aesthetically superior results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjaf006","type":"journal-article","created":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T23:15:51Z","timestamp":1736637351000},"page":"347-358","source":"Crossref","is-referenced-by-count":7,"title":["Optimizing Closed-Approach Preservation Rhinoplasty by Ultrasonic Piezo-assisted Techniques for Enhanced Precision"],"prefix":"10.1093","volume":"45","author":[{"given":"Ruben","family":"Guilarte","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Malzone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"2025031716503801400_sjaf006-B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.fsc.2020.08.003","article-title":"History of dorsal preservation surgery: seeking our historical godfather(s) for the \u201cPush Down\u201d and \u201cLet Down\u201d operations","volume":"29","author":"Kern","year":"2021","journal-title":"Facial Plast Surg Clin North Am"},{"key":"2025031716503801400_sjaf006-B2","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1056\/NEJM189902021400503","article-title":"A new method for the operative correction of exaggerated Roman nose","volume":"140","author":"Goodale","year":"1899","journal-title":"Boston Med Surg J"},{"key":"2025031716503801400_sjaf006-B3","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1056\/NEJM191405281702205","article-title":"An operation for correcting the aquiline nasal deformity; the use of new instrument; report of a case","volume":"170","author":"Lothrop","year":"1914","journal-title":"Boston Med Surg J"},{"key":"2025031716503801400_sjaf006-B4","first-page":"119","article-title":"Corrective surgery of the external nasal pyramid and the nasal septum for restoration of normal physiology","volume":"90","author":"Cottle","year":"1946","journal-title":"Ill Med J"},{"key":"2025031716503801400_sjaf006-B5","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1093\/asj\/sjx258","article-title":"The preservation rhinoplasty: a new rhinoplasty revolution","volume":"38","author":"Daniel","year":"2018","journal-title":"Aesthet Surg J"},{"key":"2025031716503801400_sjaf006-B6","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1055\/s-0041-1724031","article-title":"History of dorsum conservative techniques in rhinoplasty: the evolution of a revived technique","volume":"37","author":"Arancibia-Tagle","year":"2021","journal-title":"Facial Plast Surg"},{"key":"2025031716503801400_sjaf006-B7","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1007\/s00405-016-4306-9","article-title":"The comparison of edema and ecchymosis after piezoelectric and conventional osteotomy in rhinoplasty","volume":"274","author":"Ta\u015fk\u0131n","year":"2017","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2025031716503801400_sjaf006-B8","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1093\/asj\/sjv260","article-title":"Double-blind comparison of ultrasonic and conventional osteotomy in terms of early postoperative edema and ecchymosis","volume":"36","author":"Ilhan","year":"2016","journal-title":"Aesthetic Surg J"},{"key":"2025031716503801400_sjaf006-B9","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1159\/000506707","article-title":"Piezoelectric or conventional osteotomy in rhinoplasty? A systematic review and meta-analysis of clinical outcomes","volume":"82","author":"Tsikopoulos","year":"2020","journal-title":"ORL J Otorhinolaryngol Relat Spec"},{"key":"2025031716503801400_sjaf006-B10","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1001\/archfaci.5.5.384","article-title":"Powered instrumentation for nasal bone reduction: advantages and indications","volume":"5","author":"Davis","year":"2003","journal-title":"Arch Facial Plast Surg"},{"key":"2025031716503801400_sjaf006-B11","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1097\/scs.0b013e3180de6489","article-title":"Piezosurgery: a new method for osteotomies in rhinoplasty","volume":"18","author":"Robiony","year":"2007","journal-title":"J Craniofac Surg"},{"key":"2025031716503801400_sjaf006-B12","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1093\/asj\/sjv167","article-title":"The role of piezoelectric instrumentation in rhinoplasty surgery","volume":"36","author":"Gerbault","year":"2016","journal-title":"Aesth Surg J"},{"key":"2025031716503801400_sjaf006-B13","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.fsc.2022.08.007","article-title":"Open preservation rhinoplasty using the piezoelectric instrument","volume":"31","author":"G\u00f6ksel","year":"2023","journal-title":"Facial Plast Surg Clin North Am"},{"key":"2025031716503801400_sjaf006-B14","first-page":"41","article-title":"A review of nasal dorsal hump reduction techniques, with a particular emphasis on a comparison of component and composite removal","volume":"6","author":"Halewyck","year":"2010","journal-title":"B-ENT"},{"key":"2025031716503801400_sjaf006-B15","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.fsc.2022.08.005","article-title":"Surface techniques in dorsal preservation","volume":"31","author":"Ferreira","year":"2023","journal-title":"Facial Plast Surg Clin North Am"},{"key":"2025031716503801400_sjaf006-B16","first-page":"178","article-title":"On the \u201clet-down\u201d procedure in septorhinoplasty","volume":"35","author":"Neves Pinto","year":"1997","journal-title":"Rhinology"},{"key":"2025031716503801400_sjaf006-B17","doi-asserted-by":"publisher","first-page":"ojaa003","DOI":"10.1093\/asjof\/ojaa003","article-title":"Current trends in preservation rhinoplasty","volume":"2","author":"Daniel","year":"2018","journal-title":"Aesthet Surg J Open Forum"},{"key":"2025031716503801400_sjaf006-B18","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1093\/asj\/sjz024","article-title":"Polygon concept for the nasal tip: an aesthetic approach to rhinoplasty","volume":"39","author":"\u00c7akir","year":"2019","journal-title":"Aesthet Surg J"},{"key":"2025031716503801400_sjaf006-B19","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.fsc.2022.08.014","article-title":"My approach to preservation rhinoplasty","volume":"31","author":"\u00c7ak\u0131r","year":"2023","journal-title":"Aesthet Surg J"},{"key":"2025031716503801400_sjaf006-B20","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.fsc.2022.09.002","article-title":"Ultrasonic rhinoplasty and septoplasty for dorsum preservation and for dorsum structural reconstruction","volume":"31","author":"Gerbault","year":"2023","journal-title":"Facial Plast Surg Clin North Am"}],"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjaf006\/61439876\/sjaf006.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/45\/4\/347\/61439876\/sjaf006.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/45\/4\/347\/61439876\/sjaf006.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T12:50:46Z","timestamp":1742215846000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/article\/45\/4\/347\/7954254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,1,15]]},"published-print":{"date-parts":[[2025,3,17]]}},"URL":"https:\/\/doi.org\/10.1093\/asj\/sjaf006","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4]]},"published":{"date-parts":[[2025,1,15]]}}}