Power-Assisted Preservation Rhinoplasty: Experience in 97 Consecutive Cases

BACKGROUND: Powered tools (PTs) are emerging as effective instruments in preservation rhinoplasty, offering enhanced precision for reshaping both bone and cartilage. This study was performed to evaluate clinical outcomes and share key technical aspects from the exclusive use of PTs in dorsal preservation rhinoplasty. METHODS: A retrospective analysis was performed on 97 patients who underwent primary dorsal preservation rhinoplasty using high-speed diamond burrs, reciprocating rasps, or microsaws between January of 2021 and January of 2024. Both open and closed approaches were included. Functional and aesthetic outcomes were assessed using the RHINO scale (Rhinoplasty Health Inventory and Nasal Outcomes) at 6 and 12 months postoperatively. RESULTS: The mean improvement on the RHINO scale for breathing during sleep was +0.28 (from 3.87 to 4.15; P = 0.01). Ecchymosis lasted on average 5.6 days in patients younger than 30 years and 6.8 days in older patients. The overall complication rate was 8.5%, with a low revision rate. No major intraoperative complications were observed. CONCLUSIONS: Power-assisted preservation rhinoplasty is a safe and effective surgical strategy that provides precise control over dorsal reshaping, even when performed with a closed approach. By offering enhanced surgical control and precision, PTs can be a valid and complementary technology, ensuring optimal outcomes with reduced recovery times. The main limitations of the current study are the absence of a control group and the homogenous patient population. Further studies are encouraged to better define and compare the role of PTs in relation to piezoelectric and traditional techniques.