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TV Interview: Ultrasonic Piezo Rhinoplasty No Bone-Breaking. Dr. Mireas. TV Show:"Check-Up"(Dec2017)


Dr Mireas is speaking about "Ultrasonic Piezo Rhinoplasty" TV Show: Check-Up" in Kontra Channel (Dec

2017) Presenters: Ilias Alexakis & Sofia Neta We have a very interesting video about the Rhinoplasty procedure Can we see the third video? The method of the surgery is quite evolved Can we see the third video please? – Ok, this is the one The one with the egg? It is a highly sophisticated system, we brought it in Greece about a month ago It is called PIEZOTOME We see here some really impressive images What exactly is the system doing? You can see it in action during the video we brought from an esteemed colleague and friend Dr Göksel, So as we see here, this machine has the potential even on an egg, a non-boiled egg, it scrapes the external part only, while the egg shell is not broken

It's not broken at all That means that the machine leaves soft tissues intact This means that the machine is hard on the bones but soft on the soft tissues of the nose – Why do you use this machine? We use it for two main reasons Here it looks really impressive, we have scraped the external part but the internal remains transparent – You have scraped it off? We scrape off and we can sculpt and cut any bone we want

– Without breaking it? Without breaking the internal part – I see How do we use it? Let's say we have two uses: The one use is, for example we have a patient with a wide nose, a really thick nose but in the same time, the general morphology of the nose is that he/she has thick bones On these patients, with the old techniques, besides a small hump that we wanted to lower, we used to break the nose here and as the nose was open, we pushed the bones inwards so make the nose thinner This machine gives us the possibility to perform a bone sculpting

So you sculpt the bone? – With the older tools and techniques, we couldn't do this We are able to reduce the size, the width, without opening the inside part of the nose, without osteotomies So the patient has a better post operative period? Free from pain? – Of course Concerning the pain, if the surgery is performed correctly, we have no pain But in general, we have – Less swelling and bruising? Yes, less edema, less hematomas, we have a very smooth post operative period and if we have no ostoetomies at all, we call it Diamond Rhinoplasty because the tips of the PIEZO are made of diamonds Moreover, we can lower the hump, again without using osteotomies or rasps and in general it is a surgery that we fully control Many patients are afraid of the surgery How many hours this procedure takes? A large hump needs about one hour and twenty minutes, but usually we need to perform more improvements on a patient

When we intervene on the tip of the nose we might need two and a half, three hours – Do you use general anesthesia? Yes, we most often use general anesthesia We have no reason not to It's better for the patient Certainly with this evolution it is very important, that the post op period is lighter and the whole procedure

Because many people are afraid of this whole image, that they will be in pain, with a lot of bruising, Most important, people are afraid of breaking bones, they don't want to hear this word When they hear the phrase "we will brake the bones" "we will brake the bones", whereas with this method in a big percentage of our patients, we do not need to do anything else We just make the thick bone thinner – With the old techniques you had to break the bones, hadn't you? – Yes, of course Now, with this method things completely different We are not talking about bone breaking any more Moreover, this method has one or two important advantages, the first is that we can operate on broken or mobile bones All surgeons who operate on the nose know that there is a problem

We cannot operate someone who was injured yesterday and the nose is broken, by using the old conventional tools and technique The problem in using Piezo in rhinoplasties some years ago was that the nose is a very narrow part of the human body But these 3-4 last years, a world-class team of surgeons find the proper way and technique to use Piezo in Rhinoplasties Global pioneers like Dr Olivier Gerbault (from France) and Dr Milos Kovacevic in Germany

One must be trained abroad Do we have another video? Ok then We can play it now We can see a simple animation of the Piezo System Here we can the single and the dual version Here you can see the handle and the tips The surgeon changes the tips he/she uses according to every individual deformity Let's see the video

It's a short one Here we can see the parts of the nose The cartilage part caudally and the bony part cephalically We used to take it with the rasps, but now we can do whatever we want with the special tip We sculpt the bone – Exactly We can sculpt the bones as never before

We can sculpt even mobile bones, this is of huge importance, especially for Secondary Rhinoplasties, or for recent injuries To help someone who had a bad previous surgery How much can you lower the bone? Millimeters, centimeters? – Millimeters

The bone is not so big Some millimeters is enough, isn't it? Of course – As much as you want? Depending on what we need, if it is very thick we can lower it a lot Here, for example we have a small hump, only on the left side, we take only the local part and we will see that if it's not enough we can proceed with different tips on the side Here as we see we use the piezo to cut the nasal bone

The advantage is that it doesn't cut inside the nose, like the old osteotomy tools Whatever we do now, we do it under full and direct vision, while with the old tools we couldn't do that The other advantage is that if we go deeper, like we saw in the video with the egg shell, we will keep the inside wall intact – And symmetrical? Exactly as we want We can do exactly as we want

Till now, it was harder, like for example, when you try to cut a tile it can break into different directions, now with PIEZO we do it directly We keep total control – Moreover, the aesthetic results are better, before we used to see these scarred noses Exactly, now it is totally different Dr Mireas thank you so much for coming here today Than you for your invitation – We show all the new methods so as to inform the people

Thank you very much Dr Mireas is speaking about "Ultrasonic Piezo Rhinoplasty" TV Show: Check-Up" in Kontra Channel (Dec 2017) Presenters: Ilias Alexakis & Sofia Neta

Source: Youtube

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