PROGRAM MARCH 15

07.00 – 07.20 Ingallina – Open Rhinoplasty Anatomy videos: From Cadaver Dissection to Surgical Practice Step-by- Step
07.20 – 07.30 Heppt – Applied surgical anatomy of the nose
07.30 – 07.45 Daniel – The New Nasal Anatomy and its relevance to the days to follow
07.45 – 07.50 Q&A

07.50 – 08.00 Kosins – Preoperative Analysis and Planning for your first rhinoplasties
08.00 – 08.10 Paun – Photography and Computer Imaging for the rhinoplasty consultation
08.10 – 08.20 Sykes – Why surgeons have trouble saying No to patients?
08.20 – 08.25 Q&A

09.20 – 09.28 Rowe Jones – Opening and Closing the nose (video)
09.28 – 09.36 Bruschi – Obtaining good proportions in open rhinoplasty
09.36 – 09.44 Ghavami – Selecting the proper Profile: Dorsum and Tip Relationship
09.44 – 09.52 Cobo – Balancing the middle third of the nose using Spreader Grafts and Spreader Flaps: long term results
09.52 – 10.00 Duron – How to Support the Tip
10.00 – 10.08 East – How to create an Aesthetic Tip in primary Rhinoplasty
10.08 – 10.16 Goksel – 10 tricks I often use in rhinoplasty
10.16 – 10.24 Ghavami – Pearls for Dorsal Augmentation
10.24 – 10.32 Celik – Male Rhinoplasty: how to protect masculinity
10.32 – 10.40 Q&A
10.40 – 10.50  Robotti – A prelude to the Course – Primary rhinoplasty procedural clips: logical sequence and recent issues

The purpose of this workshop is to learn to do simple and efficient 2D rhinoplasty simulation. I will initially briefly discuss 2D and 3D simulation in general, digital imaging concepts and the use of simulation for improved patient communication. Then I will demonstrate the use of AlterImage to demonstrate how 2D simulation is performed. Then, each attendee will do simulations of their own patient on their own computer. The instructor will answer questions and provide assistance as needed. Please bring a laptop computer (1), a mouse (2) and patient images (3) to work on. (1) The simulation program you will use is Windows, so Mac users will need to already have installed Parallels or similar on their Mac. (2) The mouse is required. You will not be able to do good simulations using the touchpad. (3) Please bring a profile view of the face and a frontal view of the face so you can perform simulations on each view.

An extended subperiosteal bony vault undermining is illustrated: it allows to visualize the whole bony vault, assess the anatomic variations, and treat accurately not only the bony vault width, but also mobilize and orient each bone precisely (with piezo saws), and to sculpt precisely the bones (rhinosculpture) with special rasps or with a scraper. Moreover, with this approach, bone osteosynthesis with sutures can be easily performed for bone stabilization
PEI also allows to lower the hump precisely without opening the middle third (conservative hump removal) by doing osteotomies under direct visual control (in case of “push down”) and ostectomies (in case of “let down”), but also incremental septal trimming with a long piezo saw to allow the bony cartilaginous vault to move downwards.
Piezosurgery in rhinoplasty provides a paradigm shift in reshaping and mobilizing bones, simplifies hump removal and osteotomies, and allows us to achieve a perfectly smooth dorsum and keystone area. The techniques are easy to teach, as everything is done under direct visual control, and easy to perform.

14.00 – 14.10 Palhazi – The Anatomy you have to know (Bony Cap, Keystone, Middle Third)
14.10 – 14.25 Cerkes – Current management of the Nasal Dorsum
14.25 – 14.40 Rohrich – Restoring the Dorsal Aesthetic Lines in primary Rhinoplasty and Precision Osteotomies
14.40 – 14.50 Rowe-Jones – Osteotomies for “closing the roof”
14.50 – 15.00 Kovacevic – Spreader Flaps or Spreader Grafts: Techniques and Traps
15.00 – 15.10 Apaydin – New Spreader Flap/Graft classification
15.10 – 15.20 Q&A

15.20 – 15.30 Daniel – Evolving techniques in dorsum surgery: heading towards a Preservation Rhinoplasty?
15.30 – 15.45 Gerbault – Ultrasonic Rhinoplasty 6 years after: where are we now and what’s the future?
15.45 – 16.00 Racy – Powered Rhinoplasty : 6 years experience. Learning curve and long term results
16.00 -16.10 East – Push down? Let down? Push over?: What are the indications?
16.10 – 16.15 5 min for the Discussants
16.15 – 16.25 Q&A

16.50-17.30 Group 1 – Working on bone and middle third

• 1) Heppt – Osteotomies with Osteotome and Power Drill
• 2) Gubisch – What to do when the Keystone Septal Junction breaks
• 3) Haack – Versatility of the TTC Suture
• 4) Cerkes – New Simple Tools for bone work
• 5) Rohrich – Why Spreader Grafts Are Not Needed in most Open Primary Rhinoplasties
• 6) Zholtikov – Dorsum Preservation without osteotomy
• 7) Goksel – Open Piezo Let-down technique for lowering the dorsum
• Discussion by Reviewers (5 min)

17.30- 18.00 Group 2 – Augmenting the dorsum

• 1) Cobo – Diced cartilage + Fibrin Glue to augment a low primary dorsum
• 2) Sykes – Augmenting the dorsum with Diced Cartilage/Glue grafts
• 3) Ghavami – Dorsal augmentation: No ear, No wrap
• 4) Apaydin – Radix cocktail
• 5) Kosins – What dorsums Not to augment
• Discussion by Reviewers (5 min)

1. DEGLOVING: Heppt, Sykes (limited) vs Goksel, Kovacevic (full)
2. OSTEOTOMY: Gerbault, East (piezo) vs Calvert, Cerkes (osteotome)
3. OSTEOPLASTY:  Gerbault, Rowe Jones (piezo) vs Racy, Celik (power)

CHAIR: Rowe-Jones – Faculty will comment

1. HAACK – True subperichondral/subperiosteal flap
2. CERKES – Perichondral/periosteal flaps
3. KOSINS – Total subperichondrial/subperiosteal dissection of the tip and dorsum with identification, preservation and reattachment of ligaments
4. GERBAULT – Extended subperiosteal dissection of bony vault and dissection plane above ULC
5. GOKSEL – Dealing with Levator Labii Superior Alaque Nasi Muscle
6. DAVIS – Bony hump removal with electric oscillating saw
7. CELIK – Radix reduction and bony hump reduction with power burr
8. ROWE JONES – Bony hump reduction with piezo
9. HAACK – Prefabrication of the osteotomy lines with the coarse diamond burr
10. MAZZOLA – How to properly sharpen the chisels for a precise osteotomy
11. GUBISCH – Criss-Cross suture for bone stabilization/reconstruction of the keystone area
12. KOVACEVIC – Door-Stop implant to keep the medialized bone in position
13. GERBAULT – Ultrasonic rhinosculpture in dorsum techniques
14. GERBAULT – Piezo Open Let Down technique
15. GOKSEL – Radix augmentation
16. DANIEL – Glabellar-radix dorsal graft
17. CERKES – Combined use of spreader flaps+ spreader grafts
18. ROHRICH – Finesse in Dorsal Reshaping in Primary Rhinoplasty
19. PAUN – Diced cartilage in tissue glue technique
20. EAST – PRF/Cartilage for the dorsum