Seventh Bergamo Open Rhinoplasty Course

FINAL PROGRAM FEBRUARY 4

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 as well as in personal interest and 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.

Room A (Oggioni)

Room B (Alabastro)

MORNING SESSIONS

06.15 – 06.55 COFFEE STATION AND REGISTRATION

Room A (Oggioni)

06.55 – 7.00  Introduction and welcome

07.00 – 07.35 Session 1 – Current Anatomy: What’s New
CHAIRS: Daniel, Mazzola

07.00 – 07.20 Daniel – Keynote lecture 1 –  The Anatomical Basis of Rhinoplasty
07.20 – 07.35 Palhazi – From Cadaver Dissection to Surgical applications: contemporary anatomy and why it matters

07.35 – 08.45 Session 2 – Preoperative Analysis, patient selection, Imaging and Objective Measurements
CHAIRS: Adamson, Rowe-Jones

07.35 – 08.05 AdamsonKeynote Lecture 2 – Patient Selection and Analysis for Rhinoplasty
__Part 1:  The subjective evaluation of patients: criteria for a successful selection
__Part 2: The objective evaluation Preoperative analysis: the major parameters

08.05 – 08.12 East – Measuring Patient-Reported Outcomes in Rhinoplasty Using the FACE-Q
08.12 – 08.19 Most – Quality of life measurement in rhinoplasty
08.19 – 08.26 Apaydin – Rhinobase: A special software for record keeping and facial analysis
08.26 – 08.33 Rowe-Jones – Computers in analysis and planning
08.33 – 08.40 Haug – The value of morphing for preop analysis …or does it lead to unrealistic patient expectations?
08.40 – 08.45 Q&A

08.45 – 09.00 Rowe Jones – Special Topic: Optimising outcomes by optimising surgical performance: Flowing, not Fiddling! Are marginal gains in rhinoplasty worth the time and effort?

09.00 – 09.20 Rohrich Keynote Lecture 3 – Consistency in Rhinoplasty: getting it right the first time

09.20 – 09.40 Rohrich – Author-commented video- Applying principles in practice: a primary standard rhinoplasty step-by-step for a predictable result

09.40 – 10.00 COFFEE BREAK AND EXHIBITS

10.00 – 10.20 Case Analysis Panel
MODERATOR: Rohrich
PANELISTS: Cobo, Foda, Heppt, Gerbault

DORSUM

Session 3 will concern anatomy and aesthetics. Session 4 will address the time-tested technique of component separation- incremental reduction and subsequent reconstruction of the dorsum.  Session 5 will cover new but proven technologies for osteotomies and osteoplasty , with special focus on Piezo.  Session 6, will extensively, equitably but not without controversy, address new dorsal preservation techniques under the open approach, together with its many variations and combinations with structural technique.

10.20 – 10.45 Session 3 Anatomy and Aesthetics of the Dorsum
CHAIRS: Apaydin, East

  • Relevant Contemporary Anatomy
  • Aesthetic Ideal

10.20 – 10.28 Palhazi – Relevant anatomy: bony cap, keystone, middle vault
10.28 – 10.35 Apaydin – Precision profile planning in rhinoplasty
10.35 – 10.42 Bruschi – Intra-op measurements in open rhinoplasty to achieve proper proportions
10.42 – 10.45 Q&A

10.45 – 13.00 Session 4 – THE TIME-TESTED COMPONENT REDUCTION

The proven, dependable technique for predictably de-structuring and re-structuring the nasal dorsum to an aesthetic shape

10.45 – 11.40 Segment A: Issues and Specifics
CHAIRS: Cerkes, Calvert

  • Bony Cap and Keystone management
  • Osteotomies
  • Middle vault reconstruction: Spreader Grafts, Spreader Flaps, Variations

10.45 – 10.55 Rohrich – Restoring aesthetic dorsal lines in primary rhinoplasty by component separation, incremental reduction and precise percutaneous osteotomies
10.55 – 11.03 Heppt – Low, high, oblique, door angled osteotomies ? A guideline for osteotomies lines
11.03 – 11.11 Wurm – Revisited techniques in middle vault reconstruction
11.11 – 11.19 Apaydin – Why I am scared about push-down or let down?
11.19 – 11.27 Ferreira –  Comparing Surface versus Foundation Techniques and their predictability
11.27 – 11.35 Haug – Conventional rhinoplasty approach versus Preservation rhinoplasty: technical details and review of the literature
11.35 – 11.40 Q&A

11.40 – 12.40 Segment B : VIDEOPANEL “Elucidating Technique..”    
REVIEWERS: Gerbault, Haack
Each Panelist elucidates his/her way of performing  a specific pertinent technique by use of short video. Brief faculty discussion may follow each video – 4 min per speaker

11.40 – 11.44 Guyuron – Dorsal reduction and Spreader Grafts: the optimal dorsal lines
11.44 – 11.48 Guyuron – Controlled osteotomies
11.48 – 11.52 Calvert  – Dorsal reduction: incremental approach
11.52 – 11.56 Foda  – Component hump reduction
11.56 – 12.00 Apaydin – How I remove the bony cap and how I use spreader flaps
12.00 – 12.04 Apaydin – How to stabilize the keystone area after accidental detachment
12.04 – 12.08 Rohrich – How to reshape the DALs with spreader flaps: my 4 steps
12.08 – 12.12 Rohrich – Why the percutaneous 2 mm osteotomy is superior to other techniques: my 5 steps
12.12 – 12.16 Gubisch – Our standard technique for dorsal reduction and percutaneous osteotomies
12.16 – 12.20 Gubisch – Bone fixation by sutures: techniques and variations
12.20 – 12.24 Cobo – Spreader grafts and spreader flaps technique
12.24 – 12.28 Bruschi – Adjusting dorsal width by spreader grafts
12.28 – 12.32 Most – Autospreaders: my technique
12.32 – 12.36 Haack – Anatomic reconstruction of the middle vault with pedestal spreader grafts and spreader flaps
12.36 – 12.40 Bertossi – The Pull-Up Spreader High technique: using spreaders to project the tip

12.40 – 13.00 Segment C : VIDEOCASEPANEL “A Case in its Essentials:  Applying Technique..”  
DISCUSSANTS: Guyuron, Apaydin
Each Panelist presents a highly-condensed edited video of a clinical case, demonstrating key pertinent maneuvers. Brief discussion may follow each video. 5 min per speaker

12.40 – 12.45 Rowe-Jones – Component dorsal reduction and middle vault reconstruction with attention to the K area “transition zone”
12.45 – 12.50 Cerkes – Perichondro-periosteal flap and cartilaginous dorsum reconstruction with spreader flaps: why they work well as compared to cartilaginous dorsum preservation
12.50 – 12.55 Gubisch  – Dorsal reduction with transcutaneous osteotomies
12.55 – 13.00 Gerbault –  Keystone management in mature patient with thin unelastic skin and a significant hump

13.00 – 14.00  LUNCH AND EXHIBITS

AFTERNOON SESSIONS

14.00 – 15.40 Session 5 : FOCUS ON NEW INSTRUMENTS FOR OSTEOTOMY-OSTEOPLASTY

Advantages and applications of Piezo technology and powered instrumentation for precise osteotomy and osteoplasty. New manual instrumentation for bone work

14.00 – 14.45 Segment A: Issues and Specifics
CHAIRS: Gerbault, Most

14.00 – 14.15 Gerbault  – Bony vault reshaping with piezoelectric instruments through the full open approach
14.15 – 14.23 Zholtikov  – Piezo rhinosculpture and partial osteotomies for preservation of bone stability
14.23 – 14.31 Haack – Managing the bony vault with power tools: prefabrication of osteotomy lines  and the use of transosseous sutures for stabilization
14.31 – 14.39 Cerkes  – Use of hand instruments for bony dorsum reduction, osteotomies and osteoplasty
14.39 – 14.45 Q&A

14.45 – 15.10 Session B: VIDEOPANEL “Elucidating Technique..”
REVIEWERS: Celik, Zholtikov
Each Panelist elucidates his/her way of performing  a specific pertinent technique by use of short video. Brief faculty discussion follows each video – 4 min per speaker

14.45 – 14.49 Göksel   Piezo Ostectomy + Osteotomy combination for closing the roof
14.49 – 14.53 Most –  Piezo for Osteotomies  and shaping the bony vault
14.53 – 14.57 Rowe-Jones –  Small bone flap osteotomy and use of piezo for high and limited osteotomies
14.57 – 15.01 Duron – My way to remove the hump and reconstruct the K-area : piezo + component resection + spreader graft + bone suture
15.01 – 15.05 Celik – Power Burr for the bony dorsum and reducing the radix
15.05 – 15.09 Heppt – Lateral osteotomy under direct vision with endonasally placed osteotome and diamond burr fine contouring

15.10 – 15.40 Segment C : VIDEOCASEPANEL “A Case in its Essentials:  Applying Technique..”
DISCUSSANTS: Haack, Göksel
Each Panelist presents a highly-condensed edited video of a clinical case, demonstrating key pertinent maneuvers. Brief discussion may follow each video. 5 min per speaker

15.10 – 15.15 Gubisch – The coarse diamond burr for dorsal refinements
15.15 – 15.20 à Wengen – Motorized sagittal rasps and saws for the bony nasal dorsum: easy, fast and precise
15.20 – 15.25 Gerbault – The current sequence in hump management with piezoelectric instruments through a full open approach on a wide nose with a significant hump
15.25 – 15.30 Kosins – Use of piezosurgery on the dorsum
15.30 – 15.35 Heppt – Combined use of piezo and power tool instruments
15.35 – 15.40 Robotti  – Combining efficiently Piezo and power burr for osteotomy/osteoplasty

15.40 – 16.10 Dorsum Controversies Boxing-Ring Panel
(2 surgeons pro and 2 against – 15 min total for each topic: 5 min for first 2 surgeons to state their points, then 5min for opposing 2 surgeons, then 5min for Discussant) 
TOPICS:  DEGLOVING limited vs full,   OSTEOTOMY / OSTEOPLASTY by piezo vs osteotome
(Power tools and piezo are well accepted for osteoplasty . The main current issue is whether piezo osteotomy under a full  open approach predictably improves results)
REFEREES: Gubisch, Toriumi

  1. DEGLOVING: Cerkes, Sykes (limited) vs Kosins, Rowe-Jones (full)
  2. OSTEOTOMY: Gerbault, Zholtikov(piezo) vs Cobo, Apaydin (osteotome-rasps)

16.10 – 16.30  COFFEE BREAK AND EXHIBITS

16.30 – 19.30  Session 6 : THE PRESERVATION REVOLUTION-RESURRECTION

Contemporary dorsal preservation techniques and their anatomy-related indications, alternative or combined with structural rhinoplasty. Maintaining an aesthetic dorsum entirely, or preserving the dorsum partially when some modifications are desirable. Indications, advantages and complications of various, innovative and often confusing technical options

16.30 – 18.25 Segment A: Issues and Specifics  

Part 1: understanding the principle 
CHAIR: Daniel, Neves

16.30 – 16.45 Daniel – Dorsal preservation: an overview
16.45 – 17.00 Kosins – Classifying Dorsal Preservation: When to Use Surface versus Foundation Techniques. Understanding by use of video High Strip versus Low Strip Dorsal Preservation (Joseph vs. Cottle)

PANEL : “When I Preserve and How” 
Indications to the right dorsum to preserve  and understanding technique in 6 min
DISCUSSANTS: East, Wurm, Calvert

17.00 – 17.06 East
17.06 – 17.12 Göksel
17.12 – 17.18 Most
17.18 – 17.24 Gerbault

17.24 – 17.30 Cabbarzade
17.30 – 17.40 Discussion

Part 2: understanding variations beyond pushdown/letdown
CHAIRS: Ferreira,  Robotti

17.40 – 17.50 Neves – The Split-Tetris Preservation Rhinoplasty: how I do it
17.50 – 18.00 Ferreira –  The Spare-Roof Technique: why, when and step-by-step video
18.00 – 18.10 Robotti – Cartilaginous pushdown: the Modified Dorsal-Split Preservation Technique for humps with minor bony component
18.10 – 18.20 Kosins – Cartilage Conversion Techniques with or without removal of the bony cap: Expanding Indications for Dorsal Preservation
18.20 – 18.25 Q&A

18.25 – 19.02  Segment B : “My Way” VIDEOPANEL “Elucidating  Personal Technique..”
REVIEWERS: Most, Foda
Each Panelist elucidates his/her way of performing a specific pertinent technique by use of short video. Brief faculty discussion follows each video – 4 min per speaker

18.25 – 18.29 Cerkes – My way of cartilaginous dorsum preservation
18.29 – 18.33 Apaydin – My way of preserving the dorsum
18.33 – 18.37 à Wengen –  The new roll-down preservation technique of the cartilaginous dorsum vs Spreader Flaps
18.37 – 18.41 Gerbault – Dorsum preservation technique with bony vault stabilization through a full open approach with piezoelectric instruments
18.41 – 18.45 Most – My way for performing let-down with open approach and my Subdorsal Modified Dorsal Preservation technique
18.45 – 18.49 Göksel – How to use piezo  in open Preservation Rhinoplasty  
18.49 – 18.53 Göksel – Tricks to prevent residual hump in openPreservation Rhinoplasty and the “Ballerina maneuver”
18.53 – 18.57 East – How to Solve the Step Problem on the Radix in Preservation Rhinoplasty
18.57 – 19.02 Haack – my way to fix the dorsum and prevent a recurrence of the hump

19.05 – 19.30  Segment C : VIDEOCASEPANEL “A Case in its Essentials:  Applying Technique..”
DISCUSSANTS: Duron, Neves
Each Panelist presents a highly-condensed edited video of a clinical case, demonstrating key pertinent maneuvers. Brief discussion may follow each video. 5 min per speaker

19.05 – 19.10 Ferreira – Spare Roof Technique in a reduction rhinoplasty  with a hump and droopy tip
19.10 – 19.15 Gerbault – Dorsal preservation on a thin skined patient with a narrow dorsum and a significant hump
19.15 – 19.20 Göksel – A case of Open Preservation rhinoplasty
19.20 – 19.25 Heppt – High septal strip removal, separation and partial bone removal of perpendicular plate, osteotomies, bone fine tuning with diamond burr, vertical mattress suture to the septum
19.25 – 19.30 Robotti – Cartilaginous  pushdown  “Modified Dorsal-Split Preservation Technique” for small bony hump

19.30 – 19.45  Question-Time Panel ”Straight Question, Straight Answer!”
INTERVIEWER Robotti
PANELISTS: East, Ferreira,  Göksel, Kosins, Neves

19.45 WELCOME COCKTAIL, mingling with Faculty

MORNING SESSIONS

06.15 – 06.55 COFFEE STATION AND REGISTRATION

Room B1 (Alabastro 1)

08.00 – 13.00  Masterclasses

08.00 – 09.00 Kosins – Learning Open Preservation Rhinoplasty
09.00 – 10.00 East – Where am I going in rhinoplasty? Adapting preservation principles: what has worked and what hasn’t
10.00 – 11.00 Ferreira – Spare-Roof Technique for dorsum reduction, crooked and saddle nose
11.00 – 12.00 Göksel – Open Preservation Rhinoplasty … Patient selection, different techniques and indications, how to avoid complications
12.00 – 13.00 NevesOpen Preservation Rhinoplasty: anatomy, plane of dissection, ligaments  and the Tetris Concept:  When and How

Room B2 (Alabastro 2)

08.00 – 13.30  Masterclasses

08.00 – 09.00 Ingallina – Optimizing our results by Hyaluronic Acid: Medical Rhinoplasty and post-rhino touchups. Anatomy – Advanced techniques of injection – indications – management of complications.
09.00 – 10.30 Cerkes – Secondary Rhinoplasty- Structural Reconstruction from A to Z
10.30 – 12.00 Gubisch  – Managing the Septum as a requisite to a successful primary rhinoplasty and Correcting the Septum in secondary rhinoplasty
12.00 – 13.30 Daniel – Primary Rhinoplasty: A Progressive Approach
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13.00 – 14.00  LUNCH AND EXHIBITS

13.00 – 14.00 Lunchtime Industry Workshop

Room B (Alabastro)

AFTERNOON SESSIONS

14.00 – 20.00 Open Rhinoplasty – “THE ESSENTIALS” MODULE: from principles to practice” 

The essential steps and concepts-that-matter in open rhinoplasty to obtain a reproducible result.  This more conventionally-didactic segment is essential for surgeons starting rhinoplasty, although it serves as a refresher not-for-beginners-only. Understanding the principles of open structural rhinoplasty, their logic, application and sequence will help you to advance proficiently throughout other parts of the course.

  • Access and dissection
  • Removing the hump
  • Osteotomies
  • Restoring the midvault: spreader grafts and flaps
  • Fine-tuning the dorsum
  • Adjusting tip projection and rotation
  • Tip sutures and grafts
  • Understanding the Procedure and its Progressive Steps in the Standard Case
  • Understanding the Controversial Items which will be highlighted in the days to follow

Segment 1  Audience-Interactive VIDEO:  logic and steps of the structural open approach
CHAIR: Adamson

14.00 – 14.40 Adamson  – Understanding the basic steps and the sequence in a clinical standard case

Segment 2  Essential techniques
CHAIRS: Adamson, Celik

14.40 – 15.00 Adamson  – The Skin-Soft Tissue Envelope in Rhinoplasty
15.00 – 15.15 Cerkes  – Achieving an anatomic dorsum with structural  techniques
15.15 – 15.30 Rowe-Jones   – Osteotomies for closing the open roof and osteoplasty to refine it
15.30 – 15.45 Celik  – Spreader grafts and spreader flaps: indications
15.45 – 16.00 Adamson  – The M-Arch model of nasal tip dynamics
16.00 – 16.15 Guyuron  – Managing the underprojected and overprojected tip
16.15 – 16.25 Q&A

16.25 – 16.45  COFFEE BREAK AND EXHIBITS

16.45 – 17.00 Adamson  – Shortening, Strengthening, and Refining the Lower Lateral Cartilage
17.00 – 17.15 Heppt  – Common sutures for tip contouring
17.15 – 17.30 Sykes  – When and how to use a nasal tip graft
17.30 – 17.45 Rowe-Jones  – Managing the Droopy Tip and the Bulbous tip
17.45 – 18.00 Guyuron  – Alar Base Reduction-Reshaping
18.00 – 18.20 Wurm  – Understanding the basic steps of septoplasty (endoscopic video)
18.20 – 18.30 Q&A

Segment 3  Author-Commented audience-interactive VIDEOS:  how-to-do an open rhinoplasty
REVIEWERS: Bruschi, Sykes

18.30 – 19.00 – 1 – Cobo: Standard rhinoplasty
19.00 – 19.30 – 2 – Gubisch: Our step-by-step primary rhinoplasty
19.30 – 20.00 – 3 – Cerkes:  Standard open rhinoplasty with conventional techniques

20.00  WELCOME COCKTAIL, mingling with Faculty

nightowl
21.00 Night Owl: viewing edited  pre-recorded narrated DVDs (5 videos)

  • 1 – Haack – A male post-traumatic nose
  • 2 – Gerbault – A primary case with full open approach and ultrasonico osteotomy/osteoplasty
  • 3 – Duron – Secondary Rhinoplasty open roof, inverted V, overprojected and pinched tip, external valv collapse
  • 4 – Bruschi – Mitigating an ethnic nose (primary)
  • 5 – Daniel – The Complex Secondary – Rib & Composite Grafts