An alternative to the manual rasp, and the senior author’s preferred approach, is a powered reciprocating rasp.^11–13 These instruments can be used wherever a manual rasp would be used, but with less soft tissue trauma, especially when the site to be treated can be directly visualized. The powered instruments are especially useful to smooth the bony margins of the "open roof." Also, they are useful to correct isolated bony irregularities that may be encountered, for example, in revision rhinoplasty. When using these powered reciprocating rasps, it appears that one can obtain a more reproducible result with a lower incidence of visible or palpable bony dorsal irregularities.^11–13

There have been advances in instrumentation for powered rasping. Until recently, the author preferred the Linvatec-Hall Surgical (Linvatec Corporation, Clearwater, FL) powered rasp. This electrical powered reciprocating device is already available in many operating rooms, and a reusable rasp attachment is available. Although this rasp remains most satisfactory, the senior author has now switched to primary use of an air-driven powered reciprocating rasp (Figs. 7 and 8). The senior author believes that the higher reciprocating speed and other handling characteristics are advantageous.