Seventh Bergamo Open Rhinoplasty Course

FINAL PROGRAM FEBRUARY 5

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 – 06.45 COFFEE STATION AND REGISTRATION

Room A (Oggioni)

SEPTUM, TURBINATES , VALVES, DEVIATION and FUNCTION

Morning sessions on Functional Rhinoplasty will focus on Septum, Turbinates and Nasal Valves. The current array of septoplasty techniques will be fully addressed. Videopanels and Videocasepanels will highlight relevant techniques and case examples. A further Panel will review the functional issues which should be understood by non-ENT surgeons. Keynote lectures will address the topics of Extracorporeal Septoplasty and Deviated Nose. A Crooked Nose Videocasepanel will demonstrate personal approaches to the correction of deviated noses.

  • Septoplasty and Septal Reconstruction
  • Extracorporeal Septoplasty
  • Turbinates
  • Nasal Valves
  • Preventing and managing obstruction
  • Crooked Nose

06.45 – 09.40 Session 7 – Anatomy, septum and Valves

06.45 – 08.35 Segment A – Anatomy, Preop Analysis, Surgery of Septum and Valves
CHAIRS: Bussi, Guyuron

06.45 – 06.53 Palhazi – The Anatomy of the Septum and Nasal Valves
06.53 – 07.03 Most – Classification and treatment of septal deviations: from simple to complex and how to assess their relevance to nasal function
07.03 – 07.13 Bussi – Significant functional complications in Rhinoplasty: how to avoid them
07.13 – 07.21 Robotti – Cone Beam CT scan: a road map to surgery of septum, turbinates and bones: experience on over 500 cases
07.21 – 07.29 Haack – Reconstructing the L-Strut framework in rhinoseptoplasty: septoplasty in situ. Partial Extracorporeal, Extracorporeal
07.29 – 07.37 Cerkes – Nasal valve issues in rhinoplasty:  prevention  and treatment
07.37 – 07.45 Gerbault – Ultrasonic septoplasty for high septal deviations, septoplasty and septal harvesting
07.45 – 07.53 à Wengen  – 16 years of experience with the Titanium Breathe Implant to open the internal nasal valve
07.53 – 08.00 Q&A

08.00 – 08.15 Heppt – Special Topic: Pearls and pitfalls in septoplasty and surgery of the turbinates: From assessment to surgery

08.15 – 08.35 Gubisch Keynote Lecture 4 – Successful septoplasty for a successful rhinoplasty: how to prevent revisions in septal surgery.  Extracorporeal septoplasty as currently refined and else

08.35 – 09.40 Segment B : VIDEOPANEL “Elucidating Technique..”
REVIEWERS: Heppt, à Wengen
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 – 4 min per speaker- 2 min for videoflashes on common topic

08.35 – 08.39 Guyuron – Septoplasty and Turbinoplasty
08.39 – 08.43 Guyuron – Repair of septal perforation
08.43 – 08.47 Rohrich – straightening the septum in 3 steps and treating  the inferior turbinate
08.47 – 08.51 Cobo –  Harvesting the septum sparing the  L-Strut
08.51 – 08.55 Foda – Correction of Caudal Septum deflections
08.55 – 08.59 Göksel  – Medialization and fixation of anterior nasal spine
08.59 – 09.03 Robotti – Piezo-assisted septoplasty and turbinoplasty
09.03 – 09.11 Septal stabilization  2 min Videoflashes: stabilizing the septal framework
__Gubisch – Septal replacement – importance of strong fixation
__Apaydin – Splinting the L strut framework
__Cerkes – Septal L strut reconstruction with splinting grafts
__Robotti – Perforated ethmoid plates for straightening the septum
09.11 – 09.19 Extracorporeal septoplasty variations  2 min Videoflashes
__Haack – The subtotal extracorporeal septal reconstruction
__Wurm – Subtotal septal reconstruction for markedly deviated septum
__Most – Septal reconstruction with a modified extracorporeal septoplasty method
__Haug – Extracorporeal septoplasty simplified
09.19 – 09.29 Managing the valves  2 min Videoflashes
__Heppt – Nasal Valve lift
__Most – Lateral crural strut grafting for zone 1 lateral wall insufficiency
__Gerbault – ULC tensioning for the improvement of valve dysfunction
__Heppt – Opening of the lateral nasal wall for functional improvement
__Wurm – Managing lateral crus recurvature into the external nasal valve
09.29 – 09.33 à Wengen – The transvestibular submucous turbinoplasty with lacrimal bone removal: no bleeding no crusting
09.33 – 09.37 Lipski – Turbinotomy from the incision of vestibular skin

09.40 – 10.05  COFFEE BREAK AND EXHIBITS

10.05 – 11.30 Session 8 – Crooked Nose

Correcting the crooked nose: principles and video-case examples

CHAIR: Cerkes, Rohrich

10.05 – 10.20 Guyuron – The Deviated Nose
10.20 – 10.30 Gubisch – My Top 10 Tricks for the Deviated Noses
10.30 – 10.40 East – Treating deviated and asymmetric noses with  preservation techniques

Crooked Nose  VIDEOCASEPANEL “How I do It..”    
Each Panelist presents a highly-condensed edited video, demonstrating key maneuvers for a crooked nose correction. Brief discussion may follow each video. 5 min per speaker
DISCUSSANTS: Wurm, Göksel

10.40 – 10.45 Guyuron – Caudal node deviation in a male patient
10.45 – 10.50 Cerkes – Crooked nose correction; osteotomies and septal reconstruction
10.50 – 10.55 Cabbarzade – Partial K-stone disarticulation for correcting a deviated nose
10.55 – 11.00 Foda – Septal Surgery for the Crooked Nose
11.00 – 11.05 Haack – Correction of an extremely deviated nose with extracorporeal septoplasty and open/closed book osteotomies
11.05 – 11.10 Gerbault – Ultrasonic septoplasty and ultrasonic bone reshaping on an asymmetric face with a severe complex septal deviation
11.10 – 11.15 Rowe-Jones – Septal correction, piezo paramedian ostectomy and bone sutures
11.15 – 11.20 Göksel – Crooked Nose Preservation Rhinoplasty
11.20 – 11.25 Kosins – Crooked nose correction with low septal strip dorsal preservation
11.25 – 11.30 Robotti – Asymmetric osteotomies, bone sutures and dorsal-split preservation with overlap

11.30 – 12.00 “Selected Abstracts” Corner and prize to best presentations
(4+1 formula: 4 min presentation directly followed by 1 min discussion)
CHAIR: Lipski, à Wengen

12.00 – 13.00  LUNCH AND EXHIBITS

AFTERNOON SESSIONS

TIP

All afternoon sessions will address the TIP. Session 9 will concern anatomy and aesthetics. Session 10 will address the techniques and many variations of structural tip grafting and suturing, alar definition and nasal base issues, with a specific Panel on how to obtain adequate sidewall configuration. Session 10 will extensively, equitably but not without controversy, address new tip preservation techniques under the open approach, together with their various combinations with structural techniques.

13.00 – 13.15 Session 9 – Anatomy and Aesthetics of the Tip
CHAIR: Calvert, Persichetti

  • Relevant Contemporary Anatomy
  • Aesthetic Ideal

13.00 – 13.08 Palhazi – Relevant anatomy of the tip cartilages and ligaments
13.08 – 13.15 Göksel – What light reflexes and shadows tell us for a beautiful tip

13.15 – 16.25 Session 10 : STRUCTURAL GRAFTING AND SUTURING TECHNIQUES

The proven, dependable techniques for modifying tip support, projection, shape, and length.

13.15 – 14.20 Segment A: Issues and Specifics
CHAIR: Cervelli, Foda

  • Sutures and Grafts
  • Increasing and decreasing Projection/Length/Rotation
  • Alar Base

13.15 – 13.30 Cerkes – Adjusting tip position and projection: key techniques
13.30 – 13.45 Rohrich – Nasal Tip Sutures and role of columellar strut
13.45 – 13.55 Rohrich – Getting the alar rim contour right – 4 alar contour grafts and 5 key priniciples
13.55 – 14.05 Guyuron – Lengthening and shortening the nose
14.05 – 14.15 Adamson – Alar Base surgery and refinements
14.15 – 14.20 Q&A

14.20 – 16.22 Segment B : VIDEOPANEL “Elucidating Technique..”
REVIEWERS: Adamson, Cerkes
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- 2 min for videoflashes on common topic

TIP POSITIONING

14.20 – 14.24 Adamson – Traditional support to the nasal tip (strut, Tonge-in-Groove)
14.24 – 14.28 Calvert – Managing the caudal septum Tetrapod Concept of tip support
14.28 – 14.32 Foda – Alar Set-back technique for the overprojected tip
14.32 – 14.36 Gubisch –  Fold under flap technique and Sliding technique for deprojection
14.36 – 14.40 Kosins – Lateral steal and medial crural overlap – a powerful combination for the overprojected tip
14.40 – 14.48 Strut – 2 min Videoflashes
__Cerkes –  Advancing medial crura on columellar strut
__Cerkes –  Structuring short alar cartilages and increasing tip projection with columellar strut and LCSG
__Kosins – Tip tensioning – The option of columellar strut  plus  lateral crural steal
__Robotti  – The septal T as an anatomical strut- spacer- conformer
14.48 – 14.54 Tongue-In-Groover – 2 min Videoflashes:
__Kuzanov  – How I use the TIG
__Most – My technique for TIG  if the septum is long enough or SEG if it isn’t
__Cerkes – “Mucosal” tongue-in-groove technique
14.54 – 14.58 Gubisch – Septal Extension Grafts: Pros and Cons
14.58 – 15.14 Septal Extension Grafts variations – 2 min Videoflashes:
__Sykes – Caudal Septal Extension Graft for repositioning the tip
__Celik –  SEG with ethmoid bone
__Heppt – End to end fixation of septal extension graft
__Duron – Side-to-side fixation of SEG
__Kosins  – Tip tensioning – The option of SEG plus lateral crural steal
__Apaydin – Shoe-lace suturing of the caudal septal extension graft
__Zholtikov – Reliable SEG fixaton with changing of tip projection and rotation
__Paun – Septal extension grafts: securing the foundation

TIP SHAPING

15.14 – 15.18 Adamson – Combining Lat Crura Overlay and Lat Crura Strut
15.18 – 15.22 Adamson – The Infratip Lobule and Buttress Graft.
15.22 – 15.26 Robotti – Correcting intermediate crura excess/asymmetry
15.26 – 15.30 Sykes – Alar turn in flaps – when and how
15.30 – 15.34 Göksel – Oblique Turn Over for flattening and repositioning of the lateral crura
15.34 – 15.44 Tip Sutures and Combinations – 2 min videoflashes:
__Cerkes  – Creating the tip diamond with sutures
__Apaydin  – Tip sutures combinations
__Cobo – Domal Suture Techniques
__Sykes – Suturing techniques to contour the nasal tip
__à Wengen – A new eversion suture for the lower lateral cartilage for better eversion of the inferior edge
15.44 – 15.52 Lateral crura strut grafts variation – 2 min videoflashes:
__Kuzanov – Reinforcing weak lateral crura  by lateral crura struts)
__Zholtikov – Lateral crura modification with lateral crura strut grafts
__Duron – Correction of lateral crura convexity with deep grafts
__Most – Mini-lateral crural strut grafts
15.52 – 16.00 Articulated Grafts-Rim Grafts and variations – 2 min videoflashes
__Celik – Articulated rim grafts
__Gerbault – Articulated alar rim grafts: refinements
__Duron – Articulated grafts fixed to the deep side of the domes
__à Wengen  –  Reinforced angulated rim grafts
16.00 – 16.04 Calvert – Rim grafts versus lateral crural strut grafts
16.04 – 16.08 Toriumi – Shield tip graft with articulated alar rim grafts
16.08 – 16.14 Transposition and variations – 2 min videoflashes
__Cerkes – Lateral Crura Transposition
__Zholtikov – Lateral Crura Transposition
__Gerbault – Lateral Crura Transposition with complete control on the new LLC position and orientation
16.14 – 16.18 Haack – Controlling the supratip with a modified supratip control suture
16.18 – 16.22 Foda – Narrowing the nasal base

16.25 – 16.55 Hot Topic Panel  – My preferred tecnique for managing shape and position of the alar sidewall  
MODERATORS:  Adamson
PANELIST: Cerkes, Gerbault, Most, Robotti, Toriumi, Zholtikov

16.55 – 17.15 Toriumi Keynote Lecture 5 – Nasal Tip Contouring Based on Anatomy.

17.15 – 17.35  COFFEE BREAK AND EXHIBITS

17.35 – 20.00  Session 11  : THE PRESERVATION REVOLUTION-RESURRECTION

Contemporary, anatomy-based, preservation techniques to the tip, alternative or combined with structural rhinoplasty. True subperichondral tip dissection and ligaments preservation/reconstruction. Indications, advantages and complications

17.35 – 18.15 Segment A: Issues and Specifics:  understanding the principles  
CHAIR: Daniel, Göksel 

17.35 – 17.45 Daniel – Tip preservation founded on anatomy: principles
17.45 – 18.00 Göksel – Preservation Rhinoplasty through the open approach: an overview
18.00 – 18.10 Kosins – Why I open every tip to make it beautiful and when preservation makes it better
18.10 – 18.15 Q&A

PANEL: “What  I Preserve, When I Preserve and How”   
Indications to the right tips for  preservation techniques, understanding what is preserved and how in 5 min
DISCUSSANTS: Kosins, Calvert 

18.15 – 18.20 East
18.20 – 18.25 Göksel
18.25 – 18.30 Most
18.30 – 18.35 Kosins
18.35 – 18.40 Discussion

18.40 – 19.05  Segment B : “My Way” VIDEOPANEL “Elucidating  Personal Technique..”
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
REVIEWERS: Cabbarzade, Haug

18.40 – 18.44 Göksel – Subperichondral or supraperichondral dissection for tipplasty and How to preserve ligaments with the open approach
18.44 – 18.48 Kosins – Elevation and preservation of the skin envelope, total alar preservation and the cephalic island slide-under flap
18.48 – 18.52 East –  Minimizing resection in the tip
18.52 – 18.56 Gerbault – Tip reshaping with bidirectional tensioning and minimal LLC trimming
18.56 – 19.00 Heppt – Preservation of medial crura connecting fibres, alar perichondrium, scroll area, re-approximation of Pitanguy´s ligament
19.00 – 19.04 Neves – Tip ligaments restoring in open approach   

19.05 – 19.35  Segment C : VIDEOCASEPANEL “A Case in its Essentials:  Applying Technique..”
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
DISCUSSANTS: Paun, Celik

19.05 – 19.10 East –  Tip surgery with preservation concept
19.10 – 19.15 Kosins – Preservation of the Soft Tissue Envelope and Ligaments
19.15 – 19.20 Most – Advantages of external approach: Ability to perform external tip-plasty in conjunction with preservation
19.20 – 19.25 Gerbault – Use of LLC – SMAS connections to achieve a natural eversion of the lower lateral crura
19.25 – 19.30 Heppt – Cartilaginous tongue in groove with customized tip split for tip rotation and fixation
19.30 – 19.35 Robotti – True subperichondral dissection and avoiding tip split: is it advantageous?

19.35 – 19.50  Question-Time Panel ”Straight Question, Straight Answer”
INTERVIEWER: Robotti
PANELISTS: East, Göksel, Kosins, Most

19.50  Adjourn

20.15  SOCIAL DINNER

MORNING SESSIONS

06.15 – 06.45 COFFEE STATION AND REGISTRATION

Room B1 (Alabastro 1)

07.00 – 13.00  Masterclasses

07.00 – 08.00 PalhaziRelevant nasal anatomy for structural and preservation rhinoplasty
08.00 – 09.00 BracciniPractical use of fillers and  botulinum toxin in the nose and adjacent areas
09.00 – 10.00 FodaNasal Tip Surgery: understanding the concepts and using reproducible techniques
10.00 – 11.00 AdamsonMastering the Nasal Tip: Conceptual and Technical Components of the the M-Arch model
11.30 – 13.00 RohrichGetting it right the first time in Rhinoplasty – key finesse video steps in a primary rhinoplasty using the open approach and else

Room B2 (Alabastro 2)

07.00 – 11.00  Masterclasses

07.00 – 08.00 CoboSurgical and Non-Surgical Management of the Thick Skinned Rhinoplasty Patient.
08.00 – 09.00 ApaydinProfile Alignment: planning the profile before surgery. Analysis, imaging, planning, measuring, making profile templates and using them…
09.00 – 10.00 ZholtikovAesthetic analysis of the Nose. The importance of pre and intraop Measurements
10.00 – 11.00 Calvert Diced Cartilage and Fascia Grafts
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13.00 – 14.00  LUNCH AND EXHIBITS

12.00 – 13.00 Lunchtime Industry Workshop

Room B (Alabastro)

AFTERNOON SESSIONS

12 Author-commented, audience-interactive, specific deformity and new techniques – focused, Primary Rhinoplasty  VIDEOS

PRESERVATION and VARIATIONS
REVIEWERS: Haack, à Wengen

14.00 – 14.30 (1) East – Two videos to understand the concept of Superior and Inferior-strip Pushdown – Letdown:
__A)  A case of superior-strip pushdown: a cocaine nose with fistula closure by turbinate flap
__B)  A case of inferior-strip pushdown: developmental deviated nose
14.30 – 14.55 (2) Göksel – Open Preservation Rhinoplasty with Cottle Maneuver
14.55 – 15.20  (3) Gerbault – Cartilaginous vault preservation with conventional techniques for a small hump
15.20 – 15.45 (4) Most – Modified Let-Down Rhinoplasty via External Approach with Piezo
15.45 -16.10 (5) Kosins – The Preservation Rhinoplasty – A Case of Total Preservation of STE, Dorsum and Tip
16.10 – 16.40 (6) Ferreira -Two videos to understand applications of  the Spare-Roof Technique:
__A)  A case of SRT in the Saddle nose
__B)  A case of SRT in the Crooked nose

16.40 – 17.00  COFFEE BREAK AND EXHIBITS

STRUCTURAL
REVIEWERS: Duron, Kuzanov

17.00 – 17.25 (1) Rohrich – Bulbous asymmetric tip requiring rotation and complete tip reshaping
17.25 – 17.50 (2) Apaydin – Hump and droopy tip in a Mediterranean patient
17.50 – 18.15 (3) Heppt – Correction of boxy tip, droopy nose, broad nasal base, hump
18.15 – 18.40 (4) Foda – Open rhinoplasty in hump and underprojected tip
18.40 – 19.05 (5) Calvert – Open rhinoplasty with major septal reconstruction
19.05 – 19.30 (6) Zholtikov – Bulbous tip nose

20.30  SOCIAL DINNER