Skip to main content

Facial plastic surgery · London

Ultrasonic (piezo) rhinoplasty, with less bruising, more control.

Piezoelectric ultrasound saws and rasps cut mineralised bone with sub-millimetre control and spare soft tissue, vessels and mucosa. The result: refined bony work, 30 to 50 percent less periorbital bruising, and a calmer recovery than a traditional chisel-and-rasp rhinoplasty.

A stethoscope on a clinical desk

Indicative pricing

What piezo rhinoplasty costs privately in London.

Indicative ranges across our vetted London panel.

In short

£8,500 to £16,500, one night in hospital.

Procedure Indicative range
Consultation with piezo rhinoplasty consultant £250 to £450
Primary piezo rhinoplasty (bony work, standard tip) £8,500 to £16,500
Piezo with dorsal preservation and tip refinement £12,500 to £22,000
Revision piezo rhinoplasty £14,000 to £26,000
Functional (septoplasty or turbinate work) combined + £1,500 to £3,500
Second-opinion review of a previous rhinoplasty plan £250 to £450

Prices vary by surgeon seniority, theatre, anaesthetist fee, complexity, whether functional work is added and whether the case is primary or revision.

When it helps

The noses where piezo genuinely earns its place.

Piezo shines wherever bony work is the story: dorsal humps, osteotomies, deviated pyramids, preservation and revision. It is used within an open or closed rhinoplasty, not as a standalone technique.

  • Dorsal hump reduction

    The classic indication. The ultrasonic saw shaves the bony hump with sub-millimetre control, sparing the overlying skin, vessels and periosteum.

  • Osteotomies for a wide bony vault

    Precise, controlled cuts (lateral, medial, transverse) to narrow the nasal pyramid without the uncontrolled fractures a traditional chisel can produce.

  • Correction of a deviated nose

    Asymmetric osteotomies and bony rasping to straighten a crooked bony pyramid, often paired with septal work in the same operation.

  • Dorsal preservation rhinoplasty

    Piezo pairs beautifully with preservation techniques (Cottle, push-down, let-down) where the natural dorsum is kept and the bony base is remodelled.

  • Revision rhinoplasty

    Previously operated bone is scarred and unpredictable. Ultrasonic instruments give a controlled bite where a chisel would skid or crack.

  • Refined, feminine or ethnic reshaping

    Delicate bony reshaping in patients with thin skin, where every irregularity shows and traditional rasping leaves visible edges.

  • Not a standalone technique

    Piezo is a bony instrument used within an open or closed rhinoplasty. Tip work, cartilage grafting and skin redraping still follow standard principles.

  • Not for you if

    Purely tip-based concerns, active infection, uncontrolled bleeding disorders, unrealistic expectations or ongoing body dysmorphic concerns.

Procedure options

Piezo is a family of techniques inside a rhinoplasty plan.

What each option actually involves, and which fits which nose. The surgeon chooses the combination that matches your anatomy and goals.

  • Open piezo rhinoplasty

    A small columellar incision gives direct view of the bony vault. The default for hump reduction with tip refinement or in revision cases.

  • Closed (endonasal) piezo

    All incisions inside the nostrils. Suitable for isolated bony work in selected patients with favourable anatomy.

  • Piezo with dorsal preservation

    The natural dorsum is preserved and the bony base is remodelled (push-down or let-down). Ultrasonic cuts make the base work far more precise.

  • Piezo saw for osteotomies

    Replaces the guarded osteotome. Cuts only mineralised bone, sparing the periosteum and vessels, which drives the reduction in bruising.

  • Piezo rasp for hump reduction

    A vibrating rasp that removes bone gram by gram, leaving a smooth surface with none of the ragged edges a manual rasp can create.

  • Combined functional work

    Septoplasty, turbinate reduction or valve repair added to the same admission where breathing symptoms coexist with the aesthetic concern.

  • Revision piezo rhinoplasty

    Scarred bone, cartilage grafts and thin skin envelopes. Ultrasonic instruments give control where traditional bony instruments risk fracture propagation.

  • Second-opinion review

    A specialist review of a plan you already have from another clinic. Sometimes the honest answer is: your existing plan is right for you.

Safety and recovery

What recovery actually looks like, honestly.

Piezo does not remove the fact that rhinoplasty is major bony surgery. It reduces bruising and swelling meaningfully, and it does not shorten the 12 to 18 months your nose needs to settle.

  • General anaesthetic and a night in hospital

    Piezo rhinoplasty is done under GA. Most patients stay one night for observation, pain control and reassurance.

  • Bruising and swelling, meaningfully reduced

    Randomised trials consistently show a 30 to 50 percent reduction in periorbital bruising with piezo versus traditional bony instruments.

  • External cast for 1 week

    A rigid dorsal cast protects the newly shaped bony work for the first week. Kept dry, removed by the surgeon at the first review.

  • Internal splints for up to 2 weeks

    Soft internal splints support the septum and internal valves. Removed at 10 to 14 days in clinic, a brief and well-tolerated procedure.

  • Back to desk work at around 2 weeks

    Most patients feel presentable enough for the office at 2 weeks. Visible bruising typically settles by 10 to 14 days with piezo.

  • No exercise for 4 to 6 weeks

    No running, gym or contact sport for 4 to 6 weeks. No glasses on the bridge for 6 weeks to protect the healing bony work.

  • Numbness and tip sensation

    Transient numbness of the tip and columella is common and settles over 3 to 6 months. Persistent numbness is uncommon.

  • The result matures over 12 to 18 months

    The final refined result appears as deep swelling in the tip and supratip resolves. Judge your nose at 12 to 18 months, not 3.

  • Revision rate

    Even in expert hands, primary rhinoplasty carries a 5 to 15 percent revision rate. Ask your surgeon for their audited figure and revision policy.

Reading your operation note

Your rhinoplasty note in four parts. Read the last one first.

Whatever the approach, the note your surgeon dictates keeps to the same shape.

  1. 01 Header

    Approach, anaesthetic and timing

    Open or closed, GA duration, blood loss and whether combined functional work (septoplasty, turbinates) was performed.

  2. 02 Technique

    What was done with the piezo

    Which cuts and rasping were performed (dorsal reduction, medial and lateral osteotomies, preservation manoeuvres) and any cartilage grafts placed.

  3. 03 Findings

    Intra-operative notes and unexpected findings

    Septal deviation, valve collapse, previous scarring, any deviation from the planned procedure and the reason for it.

  4. 04 Impression

    Aftercare, splint schedule and review plan

    Read this first: cast and splint removal dates, restrictions, when to call and when to expect the 6-week, 3-month and 12-month reviews.

Recognised by major UK insurers (functional work)

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Purely cosmetic rhinoplasty is self-pay. Insurers may cover the functional component (septoplasty, valve repair) where clinically indicated.

Frequently asked

Everything we get asked about piezo rhinoplasty.

Quick answers on bruising, cost, recovery, revision, choosing a surgeon and functional versus aesthetic work.

  • How much less bruising do you actually get with piezo?

    Randomised trials and prospective series consistently show a 30 to 50 percent reduction in periorbital bruising and ecchymosis with ultrasonic piezoelectric instruments compared with a traditional chisel and rasp. The mechanism is that ultrasound only cuts mineralised bone: soft tissue, blood vessels, mucosa and periosteum are spared. Most piezo patients are presentable at 10 to 14 days rather than 3 weeks.

  • How much does piezo rhinoplasty cost privately in the UK?

    Primary piezo rhinoplasty is £8,500 to £16,500 for bony work with a standard tip. Combined dorsal preservation with tip refinement is £12,500 to £22,000. Revision piezo rhinoplasty is £14,000 to £26,000. Adding functional work (septoplasty or turbinate reduction) is usually £1,500 to £3,500 more within the same admission. Consultation is £250 to £450.

  • What is recovery like week by week?

    One night in hospital, then home with the cast and splints. External cast off at 1 week. Internal splints out at 2 weeks. Back to desk work at 2 weeks. Light exercise at 4 weeks, full exercise and gym at 6 weeks, contact sport at 8 to 12 weeks. No glasses on the bridge for 6 weeks. The nose looks refined by 3 months and continues to settle: judge the final result at 12 to 18 months.

  • Can piezo be used in revision rhinoplasty?

    Yes, and revision is one of the strongest indications. Previously operated bone is scarred, thinned and unpredictable. A traditional osteotome can skid or propagate an uncontrolled fracture. The ultrasonic saw makes a controlled cut exactly where the surgeon places it. Revision cases are longer, technically harder and priced accordingly (£14,000 to £26,000).

  • How do I choose a piezo rhinoplasty surgeon?

    Look for GMC specialist registration in plastic surgery or ENT (facial plastic subspecialty), BAAPS or BAPRAS membership, a personal case volume in piezo rhinoplasty (not just occasional cases), a 12-month follow-up protocol with photography, and a named revision policy in writing. Ask to see before-and-after photographs of noses similar to yours, not their showcase cases.

  • Can piezo fix breathing problems too, or is it purely cosmetic?

    Piezo is a bony instrument, so it does the bony half of a rhinoplasty. Functional work (septoplasty, turbinate reduction, internal or external valve repair) is added within the same operation when breathing symptoms coexist with the aesthetic concern. A well-planned rhinoplasty should leave the nose looking better and breathing at least as well as it did before.

Related treatments

Looking at the whole face?