Seventh Bergamo Open Rhinoplasty Course

FINAL PROGRAM FEBRUARY 6

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

06.30 – 06.55 COFFEE STATION AND REGISTRATION

Room A (Oggioni)

07.00 – 08.15 Session 12:  Medical and Surgical management of Thick Skin
CHAIRS: Cobo. Heppt

Controlling the difficult soft tissue envelope of the nose . Innovations in topical tratements and medications as well as surgical maneuvers

  • Pre and post op skin care protocols
  • Intraop maneuvers

07.00 – 07.15 Guyuron – Managing the nose with thick skin: key techniques
07.15 – 07.23 Kosins – Controlling the Thick Soft Tissue Envelope: Use of Ultrasound and  Accutane
07.23 – 07.31 Cobo – Surgical and non-surgical management of the Thick-Skinned Patient

My Way” PANEL “Elucidating  Personal Technique..”    
Each Panelist presents  his/her way of performing  rhinoplasty on ethnic patients  including  use of video. 5  min per speaker

07.31 – 07.36 Foda – Managing thick nasal skin
07.36 – 07.41 Celik – Thinning the nasal tip skin
07.41 – 07.46 Paun – Managing the thick skin envelope
07.46 – 07.51 Heppt – Isotretinoin and  Skin treatment in rhinoplasty patient  
07.51 – 07.56 Gubisch  – Direct skin excision in selected cases
07.56 – 08.01 Kuzanov – How we address the thick nasal skin
08.01 – 08.06 Kosins – Subdermal dissection of the nasal tip for maximum and safe defatting
08.06 – 08.15 Q&A

08.15 – 09.10 Session 13: Ethnic Nose

Nuances, specifics and potential pitfalls in Non-Caucasian rhinoplasty, relevant to different ethnic traits and patients expectations

CHAIRS: Foda, Paun

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

08.15 – 08.23 Cobo – Focusing on the Ethnic Rhinoplasty Patient
08.23 – 08.31 Paun – Is ethnicity relevant in rhinoplasty?
08.31 – 08.39 Kuzanov – 2D simulation and ethnic rhinoplasty.: how it helps  avoiding mistakes and meeting expectations

Videopanels: how I do it: ethnic-related techniques    
Each Panelist presents  his/her way of performing  rhinoplasty on ethnic patients  including  use of video. 5  min per speaker

08.39 – 08.44 Cerkes –  The Middle Eastern dorsum
08.44 – 08.49 Gerbault – Tip and alae support and reshaping on Black african nose
08.49 – 08.54 Most-  Asian Rhinoplasty
08.54 – 08.59 Cobo  – Mestizo nose rhinoplasty
08.59 – 09.04 Kosins  – Septal extension graft and tensioning for the Hispanic nose
09.04 – 09.10 Q&A

09.10 – 09.30 Guyuron Keynote Lecture 6 – Capping it all: What Makes Rhinoplasty So Enigmatic And How to Get Around it.

09.30 – 09.50 Guyuron – Author-commented video- Applying reproducible and safe principles in practice: a primary standard rhinoplasty step-by-step for a predictable result

09.50 – 10.15 COFFEE BREAK AND EXHIBITS

10.15 – 10.45 Texas-style Panel: What About this result? 

Judging results “no frills” in a primary rhinoplasty case, in a Dallas Rhinoplasty – like format

REVIEWER: Rohrich
PANELIST: Cerkes, Gubisch, Robotti, Toriumi

10.45 – 11.30 Judgement Day  Boxing-Ring Panel:  Adopt Preservation, Stay Safe and Structural, or use Shades of Grey?   Destroyers or Rebuilders?  “The importance of being Earnest”
(3 surgeons pro and 3 against for each topic:  10 min for each opposing trio to state their points, followed by challenges and conclusions by Discussants) 
DISCUSSANTS: Daniel, Rohrich
__PRESERVE : Göksel, East, Kosins
__RECONSTRUCT: Gubisch, Cerkes, Apaydin   

11.30 – 12.00 “Best Movieclip competition” and “Luca Ortelli” Bergamo Open Rhinoplasty Course award
(4+1 formula: 4 min videoclip directly followed by 1 min discussion)
CHAIR: Celik, Kuzanov

12.00 – 13.00  LUNCH AND EXHIBITS

AFTERNOON SESSIONS

The remaining afternoon sessions will mostly deal with SECONDARY RHINOPLASTY. A Panel will address the key issues on prevention, followed by the key concepts and techniques in secondary surgery. Videopanels will demonstrate established and innovative secondary rhinoplasty techniques for dorsum and tip, as well as focus specifically on rib harvesting and fabrication techniques as well as ear and DCF with related variations. A videocasepanel will exemplify didacatic cases in tighly edited video format as along the whole meeting. A Challenging Revision Cases panel will conclude secondary rhinoplasty topics. A “Camouflage and Finishing Touches” Videopanel will then highlight pearls/tips& tricks in both primary and secondary rhinoplasty and conclude the day and meeting

Session 14 – SECONDARY RHINOPLASTY

  • Preventing its occurrence
  • Principles and Techniques of Structural Reconstruction
  • Bony, midvault, tip and septum deformities
  • Functional issues
  • DCF and variations, rib and ear grafting
  • Complex challenges
  • Camouflage and Variations

13.00 – 15.55 SEGMENT A: Issues and Specifics

PART 1 Preventing secondary rhinoplasty
(avoiding preop errors in assessment and intraop errors on technique in the primary rhinoplasty)
CHAIRS: Apaydin, Haack

13.00 – 13.12 Rohrich – Why primary rhinoplasty fails (and on the importance of closing dead space)
13.12 – 13.24 Guyuron – The Common Reasons for the Dorsal and Tip Flaws and their Prevention
13.24 – 13.32 Adamson  The Failed Rhinoplasty Due to Malposition of the Lower Lateral Crus
13.32 – 13.40 Haack – What I did in the last 5 years to avoid revisions in tip surgery
13.40 – 13.48 Göksel – Reducing the risks in primary rhinoplasty so as to reduce complications and make them manageable if they occur
13.48 – 13.56 Celik –  Preventing Airway problems post rhinoplasty
13.56 – 14.04 Cabbarzade – A list of things that shouldn’t be done in rhinoplasty
14.04 – 14.10 Q&A

14.10 – 14.30 Special Video-presentation – Toriumi – Costal cartilage structural grafting: improving outcomes

PART 2 Performing secondary rhinoplasty
(the key principles and techniques in secondary rhinoplasty)
CHAIRS: Foda, Gubisch

14.30 – 14.45 Cerkes – Structural Reconstruction in secondary rhinoplasty
14.45 – 15.00 Gubisch – Use  of rib and ear cartilage in modern rhinoplasty
15.00 – 15.10 Daniel – DCF (Diced Cartilage in Fascia) grafts
15.10 – 15.18 Bussi – Long-term survival of diced cartilage for dorsal  contouring: histological findings
15.18 – 15.26 Calvert – Composite grafts: when to use them  and how
15.26 – 15.34 Gerbault – Management of bone defects  in secondary rhinoplasty
15.34 – 15.42 Göksel – Tips in revision rhinoplasty
15.42 – 15.50 Q&A

15.50 – 18.25  SEGMENT B : VIDEOPANEL “Elucidating Technique..”    
Each Panelist elucidates his/her way of performing  a specific pertinent technique by use of short video. Brief faculty discussion comments  may follow each video if time allows – 4 min per speaker – 2 min for videoflashes on common topic

Section 1 – SECONDARY DORSUM and TIP
REVIEWERS: Calvert, Neves

SECONDARY DORSUM
15.50 – 16.11 DCF Variations – 3 min Videoflashes:
__Apaydin – Cartilager chips in fascia
__Cerkes – Dorsal Augmentation with DC-RAF rectus abdominis fascia
__Zholtikov – Narrow, fixed and segmented DCF to emphasize dorsal aesthetic lines
__Cobo – Dorsal augmentation using finely diced cartilage with fibrin glue and fascia
__Duron – Use of DCF to “reconstruct a hump” in secondary rhinoplasty
__Haug – Diced Cartilage Fascia grafts and diced cartilage Fibrin grafts for dorsal reconstruction and camouflage
__Most – Dorsal augmentation with diced rib and tissue glue
16.11 – 16.17 Harvesting temporalis fascia – 2 min Videoflashes:
__Calvert
__Göksel (by hairline incision)
__Robotti
16.17 – 16.21 Harvesting rectus fascia – 2 min Videoflashes:
__Cerkes
__Robotti
16.21 – 16.25 Zholtikov – Refinement of bony pyramid and asymmetry treatment with Piezo for secondaries
16.25 – 16.29 Calvert – Dorsal reconstruction with rib cartilage
16.29 – 16.33 Apaydin – Rib laminas for dorsal augmentation
16.33 – 16.37 Rohrich – Why Fresh Frozen Rib Grafts are Better!
16.37 – 16.41 Rohrich – How to restore the secondary DAL with Fresh Frozen Spreader grafts and onlay spreader flaps
16.41 – 16.45 Celik – Use of conchal cartilage and retroauricular soft tissues in secondary rhinoplasty  for dorsum reconstruction   – combination with   Dorsally extended spreader grafts
16.45 – 16.49 Gerbault – Treatment of bone defects in secondary rhinoplasty: bone collapse, pinched bones, differential bone orientation, bone asymmetries
16.49 – 16.53 Gubisch – Problems in using DCF and how to overcome them

16.00 – 17.30 COFFEE STATION

SECONDARY TIP
16.53 – 16.57 Toriumi – Costal cartilage tip reconstruction
16.57 – 17.01 Cobo – Structural grafting in the nasal tip without using rib cartilage
17.01 – 17.05 Gubisch  – What to do after overresection of LLC and tips on the “Bending Technique”
17.05 – 17.09  Cerkes – Tip tripod reconstruction with strut grafts from the rib
17.09 – 17.13 Most – Tip/alar reconstruction with use of lateral crural struts and lateral crural replacement
17.13 – 17.17 Zholtikov – Lateral crura modification with lateral crura strut grafts
17.17 – 17.21 Apaydin – Shield grafts in revision
17.21 – 17.25 Rohrich – Role of scar tissue grafts in secondary tip reshaping and dead space closure
17.25 – 17.29 Toriumi – Premaxillary graft for tip projection

Section 2 – RIB and EAR donor sites
REVIEWERS: Robotti, Gubisch

17.30 – 17.51 RIB   a) harvesting   
(3 min videos per speaker followed by 5 min discussion at end of group)

      1. Toriumi – Rib harvesting via small incision
      2. Apaydin – Harvesting  5th, 6th, 8th and 9th costal cartilage
      3. Gerbault – Different types of rib cartilage harvesting with piezoelectric instruments
      4. Göksel – Endoscopic rib harvesting
      5. Cerkes – Partial 7th rib harvesting               
      6. Lipski – Rib harvesting: our method
      7. Robotti – Inframammary fold incision and full thickness harvesting      

17.51 – 18.06 RIB   b) segmentation-fabrication 
(3 min videos per speaker followed by 5 min discussion at end of group)

      1. Apaydin – How to carve rib cartilage
      2. Cerkes – Segmenting the rib with No11 blade
      3. Haack – Our way to create straight rib grafts
      4. Haug – The two-piece rib cartilage L span graft fabrication
      5. Most – Oblique rib cutting to avoid warping  

18.06 – 18.24 EAR  harvesting/fabrication 
(3 min videos per speaker followed by 5 min discussion at end of group)

      1. Cobo – Anterior ear harvesting techniques
      2. Guyuron – Preventing Ear Deformity Following Harversting Conchal Cartilage Graft
      3. Celik – Retroauricular approach conchal graft and fibrofatty tissue harvest for secondary rhinoplasty correction.
      4. Apaydin –  Do not forget the tragal cartilage 
      5. Haack – Fabricating the double-layered conchal strut
      6. Most – Fabricating composite graft for alar retraction

18.25 – 18.35 Robotti – Special Topic – Finesse techniques in rib grafting and the SPF-SPLF graft  : optimising outcomes for tailored dorsum contouring-augmentation

18.35 – 19.05 Panel “Challenging Revisions: what would you do for this case?”
MODERATOR: Gubisch
PANELIST: Robotti, Cerkes, Toriumi, Wurm, Zholtikov

19.05 – 19.35  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: Zholtikov, Lipski

      1. GUYURON – Soft tissue grafts in Camouflaging in Rhinoplasty
      2. ADAMSON – The Intercrural soft tissue graft
      3. COBO – Superiorly Pediculated SMAS – Ligament Flap for camouflage
      4. GUBISCH– Free diced cartilage: a perfect tool for final refinements
      5. APAYDIN– Cartilage chips for camouflage
      6. PAUN – Diced cartilage in tissue glue
      7. GÖKSEL – Turkish Dumpling (Diced cartilage in PRF Gel) and Paste Cartilage
      8. NEVES – Gel of cartilage in revision rhinoplasty
      9. CERVELLI – Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects
      10. EAST – PRF/Cartilage for the dorsum

19.35 – 19.45 Toriumi – Special Topic: M.I.S.T.A.: Microfat infused soft tissue augmentation for the nasal dorsum

19.45  Wrap-up, Farewell and  Adjourn 

MORNING SESSIONS

06.30 – 06.55 COFFEE STATION AND REGISTRATION

Room B1 (Alabastro 1)

07.00 – 13.15  Masterclasses

07.00 – 08.00 Haack – Management of the deviated nose
08.00 – 09.00 Heppt – Management of complications in rhinoplasty
09.00 – 10.00 MostFunctional rhinoplasty: classification, treatment, measurement, and outcomes
10.15 – 11.45 GuyuronPrimary Rhinoplasty Step by Step – with edited Video
11.45 – 13.15 ToriumiStructure Rhinoplasty. Maximizing Aesthetic and Functional Outcomes

Room B2 (Alabastro 2)

07.00 – 10.00  Masterclasses

07.00 – 08.00 Sykes – Management of the Cleft Lip nasal deformity
08.00 – 09.00 CelikSurgical guidelines for managing the Radix
09.00 – 10.00 Gerbault – Ultrasonic rhinoplasty (USR) through full open approach: all the steps to master USR and simplify rhinoplasty
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13.00 – 14.00  LUNCH AND EXHIBITS

12.00 – 13.00 Lunchtime Industry Workshop

Room B (Alabastro)

AFTERNOON SESSIONS

14.00 – 15.20 Parallel Session – Panel:  The Difficult/Unhappy Patient 

Tips for screening and avoiding the increasingly common problematic patients and how to deal with them once they have been operated

CHAIR: Adamson, Sykes

Detecting the problematic patient: tips from the experts
14.00 – 14.08 Adamson – The Dangerous Dozen: 12 psychologically dangerous patients  
14.08 – 14.16 Foda – How to detect a problematic patient
14.16 – 14.24 Most – The BDD (Body Dysmorphic Disorder) patient seeking rhinoplasty
14.24 – 14.32 Rohrich – How to prevent / manage the unhappy rhinoplasty patient 

Dealing with the dissatisfied patient
14.32 – 14.40 Sykes – How to deal with dissatisfied patients and why surgeons have so much trouble in saying “No” to patients in the first place
14.40 – 14.50 Kosins – How to get rid of an unhappy patient
14.50 – 15.00 Göksel  – How to manage a patient once a complication has occurred

15.00 – 15.10 Special Topic by Special Guest  – Lekakis – Body Dysmorphic Disorder: a short questionnaire plus imaging as a screening tool

15.10 – 15.20 Discussion

15.20 – 16.30 Parallel Session – Social media, marketing and building a brand

Tips for efficient marketing and a positive approach to social media

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

CHAIR: Hilbert, Cobo

15.20 – 15.35 Special Topic –  Rohrich – Why we should must be involved in social media

15.35 – 15.45 Calvert  – Digital Surgeon: Profile management and dealing with problematic reviews
15.45 – 15.55 Most –  Social media: Are we lowering the bar or raising it?
15.55 – 16.05 Sykes – Managing your reputation in 2020
16.05 – 16.15 Adamson  – Ethical standards in digital marketing
16.15 – 16.25 Göksel – Is ours a Patient’s or Surgeon’s operation?   Tips for positive marketing for happy patients
16.25 – 16.35 Discussion

16.35 – 17.05 Hot Topic Panel  – Medical Marketing: do you need it, or not?
MODERATORS: Hilbert
PANELIST: Apaydin, Duron, Most, Sykes, Göksel

16.00 – 17.30  COFFEE STATION

17.05 – 19.00 Parallel Session – Medical Rhinoplasty

The benefits and risks of medical rhinoplasty: how to inject safely, related anatomy and danger zones, and how to prevent and treat complications

  • Fillers and Botox
  • Fillers Controversies-Complications

CHAIRS: Bertossi, Sykes

17.05 – 17.20 Special Topic 1 – Sykes – how and why everyone should perform injection rhinoplasty
17.20 – 17.35 Sykes – Video of an injection rhinoplasty

17.35 – 17.45 Palhazi – How to inject safely: know your anatomy
17.45 – 17.55 Rohrich Staying safe with the use of fillers in rhinoplasty
17.55 – 18.05  East – What fillers do I use in the nose and why?
18.05 – 18.15 Ingallina –  How to optimize our results by Hyaluronic acid
18.15 – 18.25 Paun – Managing complications in medical rhinoaplasty
18.25 – 18.35 Cobo – Rhinoplasty Following Previous Filler Injections
18.35 – 18.45 Q&A

18.45 – 19.00 Special Topic 2 – Ingallina– Safe HA injections in the nose: how to choose needle or cannula to minimize complications in primary and secondary nose

19.00 – 19.20 Special “off- topic” Presentation – Toriumi – Managing the Cleft Lip Nasal Deformity