Seventh Bergamo Open Rhinoplasty Course

PROGRAM MARCH 24

The program below is the same that was originally finalized for the previously planned dates of the meeting: March 25-28, 2020.
All speakers have re-confirmed their participation, however further partial changes / updates may be possible.

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)

07.00 – 7.05  Introduction and welcome

07.05 – 07.30 Session 1 – Current Anatomy: What’s New
CHAIRS: Heppt, Mazzola

07.05 – 07.20 Palhazi – From Cadaver Dissection to Surgical applications: contemporary anatomy and why it matters
07.20 – 07.30 Neves – Planes of dissection and ligaments in open rhinoplasty

07.30 – 08.30 Session 2 – Preoperative Analysis, patient selection, Imaging and Objective Measurements
CHAIRS: Adamson, Rowe-Jones

07.30 – 07.55 AdamsonKeynote Lecture 1 – 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

07.55 – 08.02 Most – Quality of Life measurement in rhinoplasty
08.02 – 08.09 Rowe-Jones – Computers in analysis and planning
08.09 – 08.16 Haug – The value of morphing for preop analysis …or does it lead to unrealistic patient expectations?
08.16 – 08.23 East – YEO – Confidentially share and compare images/outcomes
08.23 – 08.30 Q&A

08.30 – 08.45 Rowe-Jones – Special Topic: Optimising outcomes by optimising surgical performance: Flowing, not Fiddling! Are marginal gains in rhinoplasty worth the time and effort?

08.45 – 09.05 Rohrich Keynote Lecture 2 – Consistency in Rhinoplasty: getting it right the first time

09.05 – 09.25 Rohrich – Author-commented video- Applying principles in practice: a primary standard rhinoplasty step-by-step for a predictable result

09.25 – 09.45 COFFEE BREAK AND EXHIBITS

09.45 – 10.05 Case Analysis Panel
MODERATOR: Rohrich
PANELISTS: Cobo, Foda, Gerbault, Heppt

THE 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.

10.05 – 10.20 Session 3 Anatomy and Aesthetics of the Dorsum
CHAIRS: Apaydin, East

  • Relevant Contemporary Anatomy
  • Aesthetic Ideal

10.05 – 10.13 Palhazi – Relevant anatomy: bony cap, keystone, middle vault
10.13 – 10.20 Rohrich – The Ideal Aesthetic Dorsal lines: bone, middle vault and the transition in between

10.20 – 10.35 Gerbault –  Special Topic: Why Bone stability matters: a fundamental parameter for preservation and structural bony vault and septal management

10.35 – 12.50 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

10.35 – 11.40 Segment A: Issues and Specifics
CHAIRS: Calvert, Cerkes

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

10.35 – 10.45 Rohrich – Restoring aesthetic dorsal lines in primary rhinoplasty by component separation, incremental reduction and precise percutaneous osteotomies
10.45 – 10.53 Gerbault  – Middle third management in component reduction: how an accurate keystone area rhinosculpture changes everything
10.53 – 11.01 Wurm – Revisited techniques in middle vault reconstruction
11.01 – 11.09 Heppt – Low, high, oblique, door angled osteotomies ? A guideline for osteotomies lines
11.09 – 11.17 Apaydin – Why I am scared about push-down or let down?
11.17 – 11.25 Ferreira – Predictability of  Surface versus Foundation techniques
11.25 – 11.33 Haug – Conventional rhinoplasty approach versus Preservation rhinoplasty: technical details and review of the literature
11.33 – 11.40 Q&A

11.40 – 12.36 Segment B : VIDEOPANEL “Elucidating Technique..”    
REVIEWERS: Gerbault, Haack
“How the dorsum is  de-structured and re-structured predictably and safely: component separation-  reduction
Spreaders-autospreaders, keystone reediting and camouflage”
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 Calvert  – Dorsal reduction: incremental approach
11.44 – 11.48 Foda  – Component hump reduction
11.48 – 11.52 Apaydin – How I remove the bony cap and how I use spreader flaps
11.52 – 11.56 Apaydin – How to stabilize the keystone area after accidental detachment
11.56 – 12.00 Rohrich – How to reshape the DALs with spreader flaps: my 4 steps
12.00 – 12.04 Rohrich – Why the percutaneous 2 mm osteotomy is superior to other techniques: my 5 steps
12.04 – 12.08 Gubisch – Our standard technique for dorsal reduction and percutaneous osteotomies
12.08 – 12.12 Gubisch – Bone fixation by sutures: techniques and variations
12.12 – 12.16 Robotti – Combining efficiently Power and Piezo for osteotomy/osteoplasty
12.16 – 12.20 Cobo – Spreader grafts and spreader flaps technique
12.20 – 12.24 Bruschi – Adjusting dorsal width by spreader grafts
12.24 – 12.28 Most – Spreader flaps: my technique
12.28 – 12.32 Haack – Anatomic reconstruction of the middle vault with pedestal spreader grafts and spreader flaps
12.32 – 12.36 Bertossi – The Pull-Up Spreader High technique: using spreaders to project the tip

12.36 – 12.51 Segment C : VIDEOCASEPANEL “A Case in its Essentials:  Applying Technique..”  
DISCUSSANTS: Apaydin, Davis
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

12.36 – 12.41 Rowe-Jones – Component dorsal reduction and middle vault reconstruction with attention to the K area “transition zone”
12.41 – 12.46 Cerkes – Perichondro-periosteal flap and cartilaginous dorsum reconstruction with spreader flaps: why they work well as compared to cartilaginous dorsum preservation
12.46 – 12.51 Gubisch  – Dorsal reduction with transcutaneous osteotomies

12.30 – 14.30  LUNCH STATION AND EXHIBITS

12.55 – 13.35 Lunchtime Industry Workshop
Berghaus, Robotti – Piezo Surgery for Smooth Rhinoplasty
This presentation will demonstrate interesting facts and the author‘s experience about the use of Piezo technique in nasal surgery:
• Technical background and functioning of Piezo instruments
• Comparison to classical rhinoplasty procedures
• Advantages of Piezo surgery in rhinoplasty
• Video-focus on Piezo -assisted septoplasty and turbinoplasty (Robotti)
• Results of studies and clinical cases

AFTERNOON SESSIONS

13.50 – 15.30 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

13.50 – 14.35 Segment A: Issues and Specifics
CHAIRS: Cerkes, Most

13.50 – 14.02 Gerbault  – Bony vault reshaping with piezoelectric instruments through the full open approach
14.02 – 14.10 Zholtikov  – Piezo rhinosculpture and partial osteotomies for preservation of bone stability
14.10 – 14.18 Haack – Managing the bony vault with power tools: prefabrication of osteotomy lines  and the use of transosseous sutures for stabilization
14.18 – 14.26 Cerkes  – Use of hand instruments for bony dorsum reduction, osteotomies and osteoplasty
14.26 – 14.35 Q&A

14.35 – 15.00 Segment 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

14.35 – 14.39 Göksel   Piezo Ostectomy + Osteotomy combination for closing the roof
14.39 – 14.43 Most –  Piezo for Osteotomies  and shaping the bony vault
14.43 – 14.47 Rowe-Jones –  Small bone flap osteotomy and use of piezo for high and limited osteotomies
14.47 – 14.51 Duron – My way to remove the hump and reconstruct the K-area : piezo + component resection + spreader graft + bone suture
14.51 – 14.55 Celik – Power Burr for the bony dorsum and reducing the radix
14.55 – 14.59 Heppt – Narrowing of the bony wall by osteotome, diamond burr and #15 blade

15.00 – 15.25 Segment C : VIDEOCASEPANEL “A Case in its Essentials:  Applying Technique..”
DISCUSSANTS: Haack, Zholtikov
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

15.00 – 15.05 Gubisch – The coarse diamond burr for dorsal refinements
15.05 – 15.10 à Wengen – Motorized sagittal rasps and saws for the bony nasal dorsum: easy, fast and precise
15.10 – 15.15 Gerbault – The current sequence in hump management with piezoelectric instruments through a full open approach on a wide nose with a significant hump
15.15 – 15.20 Kosins – Use of piezosurgery on the dorsum
15.20 – 15.25 Heppt – Combined use of piezo and power tool instruments

15.25 – 15.45 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: OSTEOTOMIES by Piezo vs Osteotome
(Piezoelectric technology is now well accepted for osteotomies. The main current issue is whether piezo osteotomy under a full open approach predictably improves results)
REFEREES: Davis, Gubisch

  1. OSTEOTOMY: Gerbault, Zholtikov (piezo) vs Cerkes, Cobo (osteotome)

15.45- 16.05  COFFEE BREAK AND EXHIBITS

16.05 – 19.45  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

16.05 – 17.50 Segment A: Issues and Specifics  

Part 1: understanding the principle 
CHAIR: Neves

16.05 – 16.25 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, What I Preserve and How” 
Indications to the right dorsum to preserve  and understanding technique – 6 min
DISCUSSANTS: Calvert, East, Wurm

16.25 – 16.31 East
16.31 – 16.37 Göksel
16.37 – 16.43 Most
16.43 – 16.49 Toriumi
16.49 – 16.55 Cabbarzade
16.55 – 17.05 Discussion

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

17.05 – 17.15 Neves – The Split-Tetris Preservation Rhinoplasty: how I do it
17.15 – 17.25 Ferreira –  The Spare-Roof Technique: why, when and step-by-step video
17.25 – 17.35 Kovacevic – The Subdorsal Z-flap in dorsal preservation rhinoplasty
17.35 – 17.45 Robotti – Cartilaginous pushdown: the Modified Dorsal-Split Preservation Technique for humps with minor bony component
17.45 – 17.50 Q&A

17.50 – 18.35  Segment B : “My Way” VIDEOPANEL “Elucidating  Personal Technique..”
REVIEWERS: Foda, Gerbault
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

17.50 – 17.54 Cerkes – My way of cartilaginous dorsum preservation
17.54 – 17.58 Apaydin – My way of preserving the dorsum
17.58 – 18.02 à Wengen –  The new roll-down preservation technique of the cartilaginous dorsum vs Spreader Flaps
18.02 – 18.06 Gerbault – Dorsum preservation technique with bony vault stabilization through a full open approach with piezoelectric instruments
18.06 – 18.10 Most – My way for performing let-down with open approach and my Subdorsal Modified Dorsal Preservation technique
18.10 – 18.14 Göksel – My way to use piezo  in open Preservation Rhinoplasty  
18.14 – 18.18 Göksel – Tricks to prevent residual hump in openPreservation Rhinoplasty and the “Ballerina maneuver”
18.18 – 18.22 East – How to Solve the Step Problem on the Radix in Preservation Rhinoplasty
18.22 – 18.26 Haack – My way to fix the dorsum and prevent a recurrence of the hump
18.26 – 18.35 Q&A

18.35 – 19.00  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

18.35 – 18.40 Ferreira – Spare Roof Technique in a reduction rhinoplasty  with a hump and droopy tip
18.40 – 18.45 Gerbault – Dorsal preservation on a thin skined patient with a narrow dorsum and a significant hump
18.45 – 18.50 Göksel – A case of Open Preservation rhinoplasty
18.50 – 18.55 Heppt – Let-down with high septal strip removal for hump correction
18.55 – 19.00 Robotti – Cartilaginous  pushdown  “Modified Dorsal-Split Preservation Technique” for small bony hump

19.00 – 19.35  PANEL : “…What can go wrong in Preservation??”
Avoiding complications in preservation rhinoplasty and understanding why they may happen – 6 min per speaker
DISCUSSANTS: Davis, Gubisch, Rohrich

19.00 – 19.05  A premise: Palhazi:  Anatomy pearls to avoid complications in Preservation rhinoplasty
19.05 – 19.10  Kovacevic
19.10 – 19.15  Göksel
19.15 – 19.20  Kosins
19.20 – 19.25  Neves
19.25 – 19.35  Discussion

19.35 – 19.45  Question-Time Panel ”Straight Question, Straight Answer!”
INTERVIEWER: Robotti
PANELISTS: East, Ferreira,  Göksel, Kosins, Kovacevic, Neves

19.45 WELCOME COCKTAIL, mingling with Faculty and Exhibitors

MORNING SESSIONS

06.15 – 06.55 COFFEE STATION AND REGISTRATION

Room B1 (Alabastro 1)

08.00 – 13.00  Masterclasses

08.00 – 09.00 Kosins – Beyond The Hype – The Real Deal With Incorporating Preservation Rhinoplasty Into Your Practice: Open versus Closed And Structure Versus Preservation
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 KovacevicNew  aspects of Preservation Rhinoplasty and Tip surgery
11.00 – 12.00 Göksel – Open Preservation Rhinoplasty … Patient selection, different techniques and indications, how to avoid complications
12.00 – 13.00 Neves – Open Preservation Rhinoplasty: anatomy, plane of dissection, ligaments  and the Tetris Concept:  When and How

Room B2 (Alabastro 2)

08.00 – 12.45  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 – 10.15 Cerkes – Secondary Rhinoplasty- Structural Reconstruction from A to Z
10.30 – 11.45 Gubisch  – Managing the Septum as a requisite to a successful primary rhinoplasty and Correcting the Septum in secondary rhinoplasty
11.45 – 12.45 Ferreira – Ferreira-Ishida or Spare-Roof Technique B for dorsum reduction, crooked nose, saddle nose and augmentation rhinoplasty
__

13.00 – 14.00  LUNCH AND EXHIBITS

Room B (Alabastro)

AFTERNOON SESSIONS

14.00 – 19.45 Open Structural 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, Sureyya

14.40 – 14.55 Adamson  – The Skin-Soft Tissue Envelope in Rhinoplasty
14.55 – 15.10 Cerkes  – Achieving an anatomic dorsum with structural  techniques
15.10 – 15.25 Rowe-Jones   – Osteotomies for closing the open roof and osteoplasty to refine it
15.25 – 15.40 Celik  – Spreader grafts and spreader flaps: indications
15.40 – 15.50 Adamson  – The M-Arch model of nasal tip dynamics
15.50 – 16.05 Sureyya – Tip Plasty Step-by-Step
16.05 – 16.15 Q&A

16.15 – 16.35  COFFEE BREAK AND EXHIBITS

16.35 – 16.50 Adamson  – Shortening, Strengthening, and Refining the Lower Lateral Cartilage
16.50 – 17.05 Heppt  – Common sutures for tip contouring
17.05 – 17.20 Sykes  – When and how to use a nasal tip graft
17.20 – 17.30 Rowe-Jones  – Managing the Droopy Tip and the Bulbous tip
17.30 – 17.40 Sureyya – The three main techniques for correction of the Droopy tip
17.40 – 17.55 Wurm  – Understanding the basic steps of septoplasty (endoscopic video)
17.55 – 18.05 Q&A

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

18.05 – 18.30 – 1 – Cobo: Standard structural primary rhinoplasty  
18.30 – 18.55 – 2 – Gubisch: Step-by-step primary structural rhinoplasty
18.55 – 19.20 – 3 – Cerkes:  Standard structural open rhinoplasty
18.20 – 19.45 – 4 – Sureyya: Standard structural open rhinoplasty

19.45  WELCOME COCKTAIL, mingling with Faculty

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

  1.  BRUSCHI  Mitigating an Ethnic Nose (Primary)
  2. HAACK  A male Post-Traumatic nose
  3. GERBAULT  A Primary case with Full Open Approach and Ultrasonic Osteotomy/Osteoplasty
  4. DURON Secondary Rhinoplasty: open roof, inverted V, overprojected and pinched tip, external valve collapse
  5. ROBOTTI  Secondary Rhinoplasty with finesse rib grafting