Sixth Bergamo Open Rhinoplasty Course

PROGRAM MARCH 17

Throughout the whole program you will find individual segments coded by three colors:
BASIC           INTERMEDIATE           ADVANCED
Although there is obviously wide overlap both in this classification and in individual interests irrespective of personal experience, color-coding will help you to best customize your learning track according to your learning requirements. Especially, green-coded sections should not be missed by beginners in rhinoplasty.

MORNING SESSIONS

06.15 – 06.45 COFFEE STATION AND REGISTRATION

 Room A (Oggioni)

06.45 – 07.45  Session 1: Medical Rhinoplasty 
CHAIRS: Braccini, Paun

The true benefits and risks of medical rhinoplasty will be addressed in this practical session. How to inject safely and how to prevent and treat  the dangers and potentially dramatic complications following the use of fillers will be discussed.

 

  • Fillers and Botox
  • Fillers Controversies- Complications

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06.45- 07.05 Ingallina – Medical Rhinoplasty: How to inject safely according to newest anatomical evidences
07.05 – 07.20 Braccini – Medical Rhinoplasty: how to do it (video)
07.20 – 07.35 Paun – Needle vs Knife: the true advantages and the true complications 
07.35 – 07.45 Q&A

 Room B (Alabastro)

07.00 – 13.00  6 one-hour Masterclasses
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07.45 – 08.40 Session 2: Medical and Surgical management of Thick Skin
CHAIRS: Haug, Kosins

Controlling the difficult soft tissue envelope of the nose remains a difficult challenge. Innovations in topical treatments and medications as well as surgical maneuvers will be addressed in this session.

 

  • Pre and post op skin care protocols
  • Intraop maneuvers

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07.45- 08.00 Kosins – Controlling the Thick Soft Tissue Envelope: Use of Ultrasound and efficacy of Pre-Post Treatment Skin Care Protocols
08.00 – 08.10 Cobo -Surgical and non-surgical management of the Thick-Skinned Patient
08.10 – 08.20 Davis – Management of the Nasal SMAS – Maximizing Cosmetic Outcomes in the Thick-Skinned Nose
08.20 – 08.25 Asadi – Heart-shaped SMASectomy for Thick Skin Rhinoplasty (video)
08.25 – 08.30 Kosins – Subdermal dissection of the nasal tip for maximum and safe defatting (video)
08.30 – 08.35 Celik – Thinning the skin of the nasal tip (video)
08.35 – 08.40 Q&A

08.40 – 09.50 Session 3: Ethnic Nose  
CHAIRS: Cobo, Ghavami

Nuances, specifics and potential pitfalls in Non-Caucasian rhinoplasty, relevant to different ethnic traits and patients expectations, will be addressed in this session.

 

  • Ethnic Specifics and Patient Expectations
  • Variations and Techniques  which matter

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08.40 – 08.50 Ghavami – Ethnic and Cultural considerations in Rhinoplasty
08.50 – 09.00 Daniel – Managing the Thick Skin and Wide Tip in the Ethnic Nose
09.00 – 09.10 Foda – The Middle Eastern nose
09.10 – 09.20 Cobo – The Latino nose
09.20 – 09.30 Pshenisnov – The Slavic nose
09.30 – 09.40 Kumar  – The Indian nose
09.40 – 09.50 Q&A

09.50 – 10.10 COFFEE BREAK AND EXHIBITS

10.10 – 10.30 Toriumi – Special Topic: Augmentation rhinoplasty in the Asian patient

10.30 – 11.50 Session 4: Innovations/Experimental
CHAIRS: Cervelli, Dacho

This session will focus both on promising experimental work which may lead to practical changes in rhinoplasty, as well as on what is already happening, involving Platelet-Rich-Plasma, Growth Factors, Fat Grafting and else.

 

  • Tissue Engineering
  • Adipose Tissue
  • PRP and PFP

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10.30 – 10.45 Cervelli – “Regenerative rhinoplasty”: the use of PRP membranes
10.45 – 10.53 Dacho – Growth factors in rhinoplasty: vision or reality?
10.53 – 11.01 Haug – Tissue engineering and applicable constructs for tip surgery
11.01 – 11.09 Kovacevic – PRF and cartilage scales/ PRF and microfat
11.09 – 11.14 Haug – DCF (diced cartilage fascia) and DF (diced cartilage fibrin) grafts (video)
11.14 – 11.22 Toriumi – Microfat in Rhinoplasty
11.22 – 11.30 Klinger – Modifying the damaged skin envelope by fat grafting
11.30 – 11.38 Heppt – Airstream Simulation – future or reality?
11.38 – 11.50 Q&A

11.50 – 12.05 Faculty Poll Review 2 – Key Topics on Technique

12.05 – 12.30 “Best Movieclip competition” and “Luca Ortelli” Bergamo Open Rhinoplasty Course award
(4+1 formula: 4 min videoclip directly followed by 1 min discussion)
CHAIRS: Kovacevic

  • Mcintosh Cameron (South Africa) – How to wax nasal hairs
  • Eichhorn-Sens Jacqueline (Germany) – Laterally Secured Rim Grafts
  • Elbadawy Yasser (Egypt) – Tip rhinoplasty in thick skin patient
  • Lekakis Philio (Belgium) – Lateral Crural Strut Grafts
  • Parashar Sanjay (United Arab Emirates) – Open Tip Septorhinoplasty with extracorporeal Septoplasty in patient with Ethnic Nose
  • Zimmermann Simon (Switzerland) – The Candy Cane Graft: Novel tip technique in rhinoplasty for ethnic Latino patients

12.00 – 14.00  LUNCH AND EXHIBITS

12.30 – 13.00  Room C (Stucchi) – Lunchtime Industry Workshop: Marketing communication strategy for 2018: tips and best practices

How can you build your brand and get more patients in a constantly changing ecosystem? What marketing do you need, what website, which social media and how much should you spend on it?
HELD BY: Pavel Hilbert

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Big picture of what matters and what does not in medical marketing in 2018, and why SEO is far from enough. Controversial communication strategies and online communication pitfalls that can destroy your practice Content strategies, influencer marketing, avoiding price competition, and ways of nurturing your online reputation. Straightforward tips and best practices you can adopt quickly.

13.00 – 13.30  Room B (Alabastro) – Lunchtime Industry Workshop: PRF, Cartilage Grafts and Micro Fat

The attendees will learn preparation of the new transplant generation using platelet-rich-fibrin (PRF), which is easy, fast and inexpensive.
HELD BY: Milos Kovacevic and Abdulkadir Goksel

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In this workshop we review commonly used techniques for raising the dorsum or eliminating dorsal irregularities by highlighting advantages or disadvantages inherent to each method. Within the past few years, the use of diced cartilage grafts has become the workhorse in this field. To overcome drawbacks of methods based on diced cartilage, we present a new concept for autologous augmentation, using regenerative medicine protocols. A mix of cartilage scales, cartilage patè or diced cartilage is embedded in platelet-rich-fibrin (PRF). Also, PRF can be used as a carrier for Micro Fat for the patient with damaged skin in revision rhinoplasty. This is the patient’s own highly-concentrated fibrin without additives, rich in growth factors which support the healing process.

AFTERNOON SESSIONS

 Room B (Alabastro) – BREAKOUT PARALLEL SESSIONS

13.30 – 15.30 Six Author- commented 20 min Case Videos: Variations In Primary Rhinoplasty
REVIEWERS: Haack, Pshenisnov

Six Author-commented videos will be shown on stage, demonstrating personal approaches to different cases of anatomical variations in primary rhinoplasty changes in rhinoplasty.

 

  1. Cobo – Short columella and underprojected nasal tip…
  2. Davis – Tip and dorsal refinements- septal extension graft
  3. Foda – Dorsum alignment
  4. Ghavami – Middle eastern nose
  5. Gubisch – Bulbous tip.
  6. Toriumi – Overprojected nasal tip

15.30 – 18.30 Aesthetic Nasal Reconstruction 
CHAIRS: Fischer, Mazzola

This session will focus in detail and with a logical progressive algorithm on nasal reconstruction, from small to increasingly complex nasal defects. The techniques of choice will be demonstrated and clarified by edited videos. The topic of Cleft Rhinoplasty will then be addressed in depth and  conclude the session.

 

  • Segmental/Total and Flaps of choice
  • Cleft Lip Nose and Binder Syndrome

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15.30 – 15.50 Gubisch – Special Topic: Our concept in cleft nose deformity

15.50 – 16.10 Haack – Local flaps vs. Grafts for nasal reconstruction (with video)
16.10 – 16.25 Fischer – Combined unit defects: Nose-Cheek-Lip reconstruction (with video)
16.25 – 16.45 Haack – Full thickness defects – Lining with grafts – flaps – free flaps
16.45 – 17.05 Fischer  – Considerations Framework and variations in construction
17.05 – 17.15 Haack – Forehead expansion – pros and cons
17.15 – 17.35 Fischer – Secondary nasal reconstruction
17.35 – 17.45 Haug – Unusual courses in three cases after rhinoplasty/nose reconstruction: a review of the literature and what we can learn
17.45 – 18.00 Carminati, Robotti – Reducing the framework downsizes the flaps needed for reconstruction
18.00 – 18.10  Asadi  – Cleft Lip-Nose Deformities : Three dimensional Balancing
18.10 – 18.20  Kumar – Rhinoplasty in Binder syndrome
18.20 – 18.30 Q&A

Room A (Oggioni)

13.30 – 14.20  Panel: Social Media and Building a Brand 
(3 panelists, 10 min discussion) 

CHAIRS: Rohrich, Zholtikov

This panel will focus on the importance of dealing with social media, ethically and efficiently, in the increasingly complex scenario of medical marketing.

 

  • Understanding Social Media
  • Benefits and Ethics
  • Pearls and Pitfalls

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13.30-13.45 Ghavami
13.45-14.00 Calvert
14.00-14.10 Hilbert (Marketing Specialist)
14.10-14.20 Discussion

14.20 – 16.10 Secondary Rhinoplasty  

The remaining  afternoon sessions will deal with SECONDARY RHINOPLASTY. The key issues in how to prevent it will be first discussed, followed by the key concepts and techniques in addressing it. A Secondary Rhinoplasty Hot Topics Videopanel will demonstrate, in a similar format as in the previous days,  both time-established and innovative techniques of  reconstruction of the dorsum and tip. After a videopresentation on using costal cartilage for structural grafting, a specific Rib Techniques Videopanel will address both rib harvesting and segmentation/fabrication techniques. A “Boxing-Ring” panel will shed light on the controversy of using rib or not , followed by a Secondary RhinoplastyTechniques Videofocus session which will highlight by the use of short tightly-edited videoclips specific operative details and personal pearls.The day will end with a “Camouflage and Finishing Touches” Videopanel regarding pearls/tips& tricks in both primary and secondary rhinoplasty.

 

  • Preventing its occurrence
  • Psychology and patient Selection
  • Principles and Algorithms
  • Bony, midvault and septum deformities
  • Tip deformities
  • Functional issues
  • Complex challenges
  • Structural Reconstruction
  • Camouflage and new Cartilage Variations

14.20 – 14.40  Special Topic: Preventing a secondary rhinoplasty
(on preop errors in assessment and intraop errors on technique)

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14.20 – 14.30 Rohrich – When to say no, how and why
14.30 – 14.40 Rohrich – Why primary rhinoplasty fails, (and on the importance of closing dead space)

14.40 – 16.15  Performing  secondary rhinoplasty
CHAIRS: Apaydin, Cerkes

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14.40 – 14.45 à Wengen – First: Save your neck in Rhinoplasty: tips and tricks in the OR to reduce surgeon’s neck pain
14.45 – 14.55 Cerkes – Treatment of the Overresected Nose
14.55 – 15.05 Daniel – DCF (Diced Cartilage Fascia) to the dorsum in secondary rhinoplasty
15.05 – 15.15 Foda – Destroyed tip support: is rib cartilage mandatory?
15.15 – 15.25 Cobo – Structural grafting in the nasal tip without using rib cartilage
15.25 – 15.35 Davis – Working with autologous rib cartilage-optimizing results
15.35 – 15.45 Robotti – Pearls on using rib in revision rhinoplasty
15.45 – 15.55 Apaydin – Three different ways to augment major saddling
15.55 – 16.05 Calvert – Composite grafts: when and how
16.05 – 16.15 Q&A

16.00 – 17.30  COFFEE STATION AND EXHIBITS

16.15 – 16.35  Toriumi – Video-Presentation: Structural Grafting Using Costal Cartilage

16.35 – 17.35 Secondary Rhinoplasty Hot Topics Videopanel
(5 min video-based presentations in each group followed by 5 min discussion at end of each group) 
REVIEWERS: Gubisch, Toriumi

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16.35 – 17.05 Group 1 – Working on dorsum

  • 1) Toriumi – Dorsal grafting with solid costal cartilage
  • 2) Gubisch – Rib grafts for aesthetic dorsal lines
  • 3) Calvert – the DCF (Diced Cartilage Fascia) construct for the dorsum
  • 4) Cerkes – The DC-RAF graft (Diced Cartilage-Rectus Abdominis Fascia)
  • 5) Robotti – The SPF graft (Sandwich Perichondrium-Fascia): solving the dilemma between definition and edge visibility
  • Discussion by Reviewers (5 min)

17.05- 17.35 Group 2 – Working on tip

  • 1) Cerkes– Dome reconstruction using the remnants of the lateral crura
  • 2) Davis – AARG (Articulated Alar Rim Graft) for treating post-surgical alar retraction
  • 3) Foda – Conchal cartilage reconstruction of battered nasal tips and ear cartilage columellar strut
  • 4) Gubisch – Bending technique for reconstruction of the lower lateral cartilages  and what to do when bending fails
  • 5) Toriumi – Composite Grafting and managing Nasal Vestibular Stenosis
  • Discussion by Reviewers (5 min)

17.35 – 17.55 Rib Techniques  Videopanel (Part 1) Harvesting Techniques Videopanel 
(3 min videos per speaker followed by 5 min discussion at end of group)
REVIEWERS: Davis, Robotti

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  • 1) CERKES – Partial rib harvest
  • 2) TORIUMI – Mini-incision rib harvesting
  • 3) ROBOTTI – Inframammary fold incision and full thickness harvesting
  • 4) GERBAULT – Piezo Rib Graft Harvesting
  • 5) GOKSEL – Endoscopic rib harvesting
  • Discussion by Reviewers (5 min)

17.55 – 18.10 Rib Techniques Videopanel (Part 2) Segmentation-Fabrication Techniques
(3 min videos per speaker followed by 6 min discussion at end of group)

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  • DAVIS – Fabricating grafts that serve the purpose from rib: lamination and finesse
  • APAYDIN – Oblique Split Technique and using a “Chef’s Knife”
  • CERKES – Segmenting the Partial rib harvest
  • Discussion by Reviewers (5 min)

18.10 – 18.30 Secondary Rhinoplasty Controversies Boxing-Ring Panel
(3 surgeons pro and 3 against: 6 min for each opposing trio to state their points followed by 8 min discussion by and between referees)
TOPIC:  Is using RIB Essential or Unnecessary?
REFEREES: Rohrich, Toriumi

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  1. Essential:  Davis, Gubisch, Calvert
  2. Unnecessary:  Cobo, Foda, Ghavami

18.30 – 19.10 “Secondary Rhinoplasty techniques (non- rib) Videofocus” (videoclips-only session)
(3+1 formula: 3 min videoclip directly followed by 1 min discussion)
CHAIR: Foda – Faculty will comment

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  1. ROHRICH – Scar tissue preservation / Scar reshaping in revision rhinoplasty
  2. GHAVAMI – Overprojected tip correction (secondary)
  3. HEPPT – Ear Cartilage Harvest and postauricular approach to Temporalis Fascia harvesting
  4. GOKSEL – How to harvest Temporalis Fascia
  5. HAUG – Tragus as a donor site for small cartilage grafts
  6. HAACK – Septum Reconstruction with a Double-Layered Conchal L-Strut
  7. ANTOHI – Dorsal augmentation with diced cartilage and retroauricular fascia complex “pocket” graft
  8. FODA – Ear cartilage Columellar Strut
  9. FODA – Dealing with Tip Bossa
  10. HEPPT – Premaxilla Fixation in Revisional Crooked Nose surgery

19.10 – 19.45  Camouflage and Finishing Touches in primary and secondary rhinoplasty – personal preferences –  Videopanel
(3 min videos followed by 5 min discussion at end of videopanel)
REVIEWERS: Duron, Kovacevic

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  • 1) CELIK – Camouflage with retroauricular fascial tissues
  • 2) ANTOHI – Dorsum and sidewall camouflage with Diced Cartilage and Diced Retroauricular Fascia complex in secondary rhinoplasty
  • 3) DURON – Camouflage of the tip with deep temporalis fascia
  • 4) GHAVAMI – Diced cartilage or Crushed cartilage?
  • 5) GUBISCH – Free diced cartilage
  • 6) APAYDIN – Cartilage chips for camouflage
  • 7) ZHOLTIKOV – Camouflage: my preferences
  • 8) GOKSEL – Paste Cartilage for fine tuning
  • 9) COBO – Final touches in rhinoplasty
  • 10) GOKSEL – How to get better lights on the tip of the nose
  •  Discussion by Reviewers (5 min)

19.45 Wrap-up, Farewell and  Adjourn