PRS Plastic and Reconstructive Surgery · 2021

Powered Rhinoplasty: A Simple Step-by-Step Approach

Racy E, Fanous A, Benmoussa N.

What this paper says

A technique article describing powered bone cutting in rhinoplasty step by step, on the argument that mechanical instruments give more reproducible fracture lines than manual chisels.

Overview

Lowering the hump and narrowing the base of the nose are routine steps in first time rhinoplasty. The stated difficulty is obtaining stable fracture lines, a natural appearance, clean bridge lines and no visible or palpable irregularities, particularly over the long term. The authors describe powered osteotomy as a guideline for surgeons.

Sections of note

Technique article; the abstract reports no patient numbers, no outcomes, no complication rates and no follow up.
Hump reduction and nasal base narrowing are named as very common steps in primary rhinoplasty.
The stated goals are stable fracture lines, natural appearance, well defined dorsal aesthetic lines and no palpable or visible irregularities in the long term.
The authors state reproducibility seems more feasible with mechanical osteotomies, powered or piezoelectric, than with traditional manual osteotomies.
The stated aim of the article is a clear step by step guideline.

What it means for a patient

Osteotomy means cutting the nasal bones so they can be repositioned, which is what narrows the nose.
Where those cuts break determines whether the result is smooth or leaves a ridge that can be felt.
The claim that powered instruments are more reproducible carries no supporting data in the abstract.
No comparison with manual technique is reported.

Why this paper matters

Bone cutting has been done with hand chisels for most of the history of rhinoplasty, and powered and ultrasonic instruments are the main recent change to that step. This article documents the powered method in sequence. Whether it reduces irregularities compared with manual cuts is not measured here.

Terms

Osteotomy: a controlled cut in bone so it can be repositioned.
Powered osteotomy: bone cutting with a motorized instrument rather than a hand chisel.
Piezoelectric: cutting bone using high frequency vibration.
Dorsal aesthetic lines: the two shadow lines running down the bridge from the brows to the tip.
Primary rhinoplasty: a first operation on a nose with no previous surgery.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Reduction of a nasal hump and nasal base narrowing are very common steps during a primary rhinoplasty procedure. The greatest difficulty is to obtain stable fracture lines, a natural appearance, beautiful dorsal aesthetic lines, and the absence of palpable or visible irregularities, especially in the long term. The…”

Excerpt; the full abstract is on PubMed.