When people start researching where to get a nose job, they inevitably come across two specialist profiles: the plastic surgeon and the maxillofacial surgeon. And at that point a legitimate question arises that very few websites answer clearly: can a maxillofacial surgeon perform a rhinoplasty?
The answer is yes. But the story is more interesting than that.
The specialty that carries the nose in its DNA
Oral and maxillofacial surgery is a dual-degree specialty — medicine and dentistry — covering the entire region of the head, face, neck and facial bone structures. The nose is not unfamiliar territory for this specialist: it is their natural ground.
Throughout specialist training, the maxillofacial surgeon works specifically and continuously with nasal fractures, craniofacial reconstructions, facial bone osteotomies and septum surgery. While the plastic surgeon spreads their training across the trunk, limbs, breast and face, the maxillofacial surgeon concentrates virtually their entire learning curve on the region that runs from the forehead to the chin.
This is no minor detail when it comes to operating on a nose. The nose is, anatomically, a complex structure made up of bone, cartilage and soft tissue coexisting in a very small space. Understanding how those three layers interact — and how a modification in one affects the others — requires precisely the kind of knowledge that maxillofacial training builds over years.
Why ultrasonic rhinoplasty amplifies this advantage
Ultrasonic rhinoplasty is the most significant evolution in nose surgery over the last two decades. Instead of using chisels and mallets to work the nasal bone — as traditional rhinoplasty does — it uses a piezoelectric scalpel that emits ultrasonic vibrations capable of cutting and sculpting bone with millimetre precision, without damaging the surrounding soft tissues.
This distinction is crucial. The piezoelectric scalpel only acts on mineralised tissue — bone and calcified cartilage — and stops automatically when it comes into contact with soft tissue such as skin, mucosa or nerves. The result is a more controlled procedure, with less bruising, less post-operative swelling and a significantly faster recovery than the conventional technique.
That said, handling this instrument with the required skill is not something learned over a weekend. It demands a very deep knowledge of the bone anatomy of the mid-facial third. And that knowledge, precisely, is what defines the maxillofacial specialty.
A surgeon who has spent years working on osteotomies, reconstructions and fractures of the facial architecture has a relationship with bone that few specialists can match. They know how nasal bone behaves under tension, how to predict its response to cutting, and how to respect structural support vectors so the nose not only looks right aesthetically but retains its respiratory function intact.
Aesthetics and function: the two sides of a well-done rhinoplasty
One of the historical criticisms of past rhinoplasties is that many prioritised the aesthetic result without adequately considering nasal function. Operated noses that looked visually slimmer, but compromised the patient’s breathing in the long term.
This problem has a lot to do with the specialist’s approach. A surgeon whose training focuses primarily on aesthetics may lose sight of the structural engineering of the nose. A maxillofacial surgeon, whose training includes functional septum surgery, treatment of nasal turbinate hypertrophy, correction of deviated septa and complete rhinoseptoplasties, naturally integrates aesthetic and functional objectives in a single procedure.
This is especially relevant when the patient has pre-existing respiratory problems — difficulty breathing through the nose, snoring, mild apnoeas — that can be addressed simultaneously during the operation, thus avoiding a second surgery.
The question you should actually ask your surgeon
The specialty on the degree certificate matters less than the real-world experience with the specific technique you are going to use. A maxillofacial surgeon who has performed hundreds of ultrasonic rhinoplasties is infinitely more reliable than any other specialist with little experience in this specific technique, regardless of their qualification.
What you can — and should — demand is:
- Accredited training in ultrasonic rhinoplasty, not just conventional rhinoplasty.
- Documented real cases with before-and-after photographs.
- The ability to address nasal function, not just aesthetics.
- A first consultation where the surgeon listens, analyses your specific anatomy and explains which technique is most suitable for you.
Rhinoplasty simulation before the operation is another tool that sets the most prepared teams apart: it aligns expectations and allows the result to be planned before entering the operating theatre.
Where to have surgery: Valladolid and Santander
Dr Álvaro Pérez Villar is an oral and maxillofacial surgeon specialising in ultrasonic rhinoplasty. He performs procedures in Valladolid and at Hospital Santa Clotilde in Santander, where he also operates through Clínica Pérez Villar in Cantabria, a centre offering a wider range of facial surgery and aesthetic medicine treatments for patients from northern Spain.
Ultrasonic rhinoplasty in Santander has made this technique accessible to patients from Cantabria, the Basque Country and La Rioja who previously had to travel to Madrid or Barcelona to find a specialist with this profile.
What patients who have faced this decision say
Many patients who have surgery with Dr Pérez Villar arrive after having consultations with plastic surgeons. The common thread in their accounts is surprise: they did not expect a maxillofacial surgeon to have such detailed knowledge of the nose, nor that the difference in the quality of the technical explanation would be so marked.
Patient reviews of ultrasonic rhinoplasty reflect exactly that point: trust does not come from the qualification, but from the conversation in the consultation room, from feeling that the doctor has understood what you want and knows how to achieve it.
One last thing before you decide
If you are considering a nose operation and have doubts about which type of specialist to choose, basic training matters — but it is not the only criterion. What truly determines the quality of the result is the combination of three things: the technique used, the accumulated experience with that technique and the surgeon’s ability to listen and adapt the plan to your specific anatomy.
Ultrasonic rhinoplasty performed by a specialist maxillofacial surgeon is not a rarity or a niche alternative. In many cases, it is the most solid combination you can find.
If you would like to find out whether you are a candidate and which technique would be most appropriate for your case, you can request a free online medical assessment with no commitment.
References and further reading:
· Spanish Society of Oral and Maxillofacial Surgery (SECOM): secom.org
· Rhinoplasty Society: rhinoplastysociety.org
· Role of maxillofacial surgery in rhinoplasty — Journal of Cranio-Maxillofacial Surgery, 2023 review.
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