Seventh Bergamo Open Rhinoplasty Course

PROGRAM MARCH 25

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 – 06.45 COFFEE STATION AND REGISTRATION

Room A (Oggioni)

THE SEPTUM, TURBINATES , VALVES 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
  • Endoscopy

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, Rowe-Jones

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 àWengen  – 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 3 – Successful septoplasty for a successful rhinoplasty: how to prevent revisions in septal surgery.  Extracorporeal septoplasty as currently refined and else

08.35 – 09.35 Segment B : VIDEOPANEL “Elucidating Technique..”
REVIEWERS: àWengen, Paun
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

08.35 – 08.39 Rohrich – Straightening the septum in 3 steps and treating  the inferior turbinate
08.39 – 08.43 Cobo –  Harvesting the septum sparing the  L-Strut
08.43 – 08.47 Foda – Correction of caudal septum deflections
08.47 – 08.51 Goksel –  Medialization and fixation of anterior nasal spine
08.51 – 08.55 Robotti – Piezo-assisted septoplasty and turbinoplasty
08.55 – 09.05 Stabilizing the septal framework – 2 min Videoflashes:
__Gubisch – Septal replacement – importance of strong fixation
__Apaydin – Splinting the L strut framework
__Cerkes – Septal L strut reconstruction with splinting grafts
__Paun – Use of  the Clocking Suture to help straighten the mid third
__Robotti – Perforated ethmoid plates for straightening the septum
09.05 – 09.13 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
09.13 – 09.23 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
09.23 – 09.27 Bussi – Standard Turbinoplasty within a rhinoplasty
09.27 – 09.31 àWengen – The transvestibular submucous turbinoplasty with lacrimal bone removal: no bleeding no crusting

09.30 – 09.50  COFFEE BREAK AND EXHIBITS

09.50 – 11.20 Session 8 – Crooked Nose

Correcting the crooked nose: principles and video-case examples

09.50 – 10.35 Segment A: Issues and Specifics
CHAIR: Cerkes, Rohrich

09.50 – 10.05 Gubisch – My Top 10 Tricks for the Deviated Noses
10.05 – 10.17 Sureyya – Treating the crooked nose with Structural Rhinoplasty
10.17 – 10.29 East – Treating Aeviated and Asymmetric noses with  Preservation Rhinoplasty
10.29 – 10.35 Q&A

10.35 – 11.20 Segment B: 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: Foda, Wurm

10.35 – 10.40 Cerkes – Crooked nose correction; osteotomies and septal reconstruction
10.40 – 10.45 Cabbarzade – Partial K-stone disarticulation for correcting a deviated nose
10.45 – 10.50 Foda – Septal Surgery for the Crooked Nose
10.50 – 10.55 Haack – Correction of an extremely deviated nose with extracorporeal septoplasty and open/closed book osteotomies
10.55 – 11.00 Gerbault – Ultrasonic septoplasty and ultrasonic bone reshaping on an asymmetric face with a severe complex septal deviation
11.00 – 11.05 Rowe-Jones – Septal correction, piezo paramedian ostectomy and bone sutures
11.05 – 11.10 Göksel – Crooked Nose Preservation Rhinoplasty
11.10 – 11.15 Kosins – Crooked nose correction with low septal strip dorsal preservation
11.15 – 11.20 Robotti – Osteoplasty, osteotomies, and dorsal-split cartilaginous pushdown  with overlap

11.20 – 12.00 “Selected Abstracts” Corner and prize to best presentations
(4+1 formula: 4 min presentation directly followed by 1 min discussion)
CHAIR: àWengen, Heppt

Turacli – An innovative tipplasty technique: medial crural composite flap
Elbadawy – Columellar strut Versus Septal extension graft in open Rhinoplasty
Declau – Piezo-assisted and conventional turbinoplasty in external septorhinoplasty: aprospective comparative study in 100 patients
Hani Nasal Radix
Assiri – A Novel Technique for Spreader Flap by Folding Dorsal Hump in Primary Rhinoplasty Patients
La Padula – The use of posterior auricular fascia for slight dorsal augmentation and irregular dorsum coverage in primary and revision open rhinoplasty: a prospective study
Brajendra – Role of Early surgical intervention in management of Binder’s nose deformity
Battista – Innovation in Rhinoseptoplasty Diagnostics: Ultrasound Biomicroscopy

12.00 – 14.00  LUNCH STATION AND EXHIBITS

 

12.00 – 12.40 Lunchtime Industry Workshop
East, Gerbault, Göksel – Ultrasonic rhinoplasty for Dorsum Preservation rhinoplasties: the instruments, approaches and techniques
Ultrasonic rhinoplasty experts will detail how to safely begin with piezoelectric surgery in dorsum preservation (DP), and how to optimize results and avoid traps.
The specific instruments and techniques for the distinct types of DP will be detailed.

AFTERNOON SESSIONS

THE 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 – 16.20 Session 10 : STRUCTURAL GRAFTING AND SUTURING TECHNIQUES

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

13.15 – 14.15 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 – 13.40 Rohrich – Nasal Tip Sutures and role of columellar strut
13.40 – 13.45 Rohrich – Getting the alar rim contour right – 4 alar contour grafts and 5 key priniciples
13.45 – 13.55 Sureyya  The (Structural) Secret of Tip Stability
13.55 – 14.05 Adamson – Alar Base surgery and refinements
14.05 – 14.10 Rohrich –  How to make Alar Base surgery simple, safe and with a great outcome
14.10 – 14.15 Q&A

14.15 – 16.18 Segment B : VIDEOPANEL “Elucidating Technique..”
REVIEWERS: Adamson, Wurm
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

14.15 – 14.19 Adamson – Traditional support to the nasal tip (strut, Tonge-in-Groove)
14.19 – 14.23 Calvert – Managing the caudal septum Tetrapod Concept of tip support
14.23 – 14.27 Foda – Alar Set-back technique for the overprojected tip
14.27 – 14.31 Gubisch –  Fold under flap technique and Sliding technique for deprojection
14.31 – 14.35 Kosins – Lateral steal and medial crural overlap – a powerful combination for the overprojected tip
14.35 – 14.43 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
14.43 – 14.49 Tongue-In-Groove and  variations –  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
14.49 – 14.53 Gubisch – Septal Extension Grafts: Pros and Cons
14.53 – 15.07 Septal Extension Grafts and variations – 2 min Videoflashes:
Celik –  SEG with ethmoid bone
__Heppt – End to end fixation of septal extension graft
__Duron – Side-to-side fixation of SEG
__Davis – Tip tensioning –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 – SEGs: securing the foundation

TIP SHAPING

15.10 – 15.14 Adamson – Combining Lat Crura Overlay and Lat Crura Strut
15.14 – 15.18 Adamson – The Infratip Lobule and Buttress Graft.
15.18 – 15.22 Robotti – Correcting intermediate crura excess/asymmetry
15.22 – 15.26 Göksel – Oblique Turn Over for flattening and repositioning of the lateral crura
15.26 – 15.30 Kovacevic– Cranial Tip Suture and its rationale
15.30 – 15.38 Tip Sutures and Combinations – 2 min videoflashes:
__Cerkes – Creating the tip diamond with sutures
__Apaydin – Tip sutures combinations
__Cobo – Domal Suture Techniques
àWengen – A new eversion suture for the lower lateral cartilage for better eversion of the inferior edge
15.38 – 15.46 Lateral Crura Strut Grafts and variations – 2 min videoflashes:
   Most – Mini-lateral crural strut grafts
   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_
15.46 – 15.50 Davis – Articulated Rim Grafts and their rationale
15.50 – 15.58 Articulated Grafts-Rim Grafts and variations – 2 min videoflashes:_
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Davis –  Articulated Grafts: shaping and fixating
    Celik – Butterfly rim grafts
__Duron –   Articulated grafts fixed to the deep side of the domes
__àWengen  –  Reinforced angulated rim grafts
15.58 – 16.02 Calvert – Rim grafts versus lateral crural strut grafts
16.02 – 16.06 Toriumi – Shield tip graft with articulated alar rim grafts
16.06 – 16.10 Transposition and variations – 2 min videoflashes:
__Cerkes – Lateral Crura Transposition
__Zholtikov – Lateral Crura Transposition
16.10 – 16.14 Haack – Controlling the supratip with a modified supratip control suture
16.14 – 16.18 Foda – Narrowing the nasal base

16.20 – 16.40 Toriumi Keynote Lecture 4 – Nasal Tip Contouring Based on Anatomy.

16.40 – 17.00 Davis Keynote Lecture 5 – Lateral Crura Recurvature: how to enhance function and optimize stability through Lateral Crura preservation and tensioning

17.00 – 17.30 Hot Topic Panel  – My preferred tecnique for managing shape and position of the alar sidewall  
MODERATORS:  Adamson
PANELIST: Cerkes, Davis,  Gerbault, Most, Robotti, Toriumi

16.25 – 17.35  COFFEE STATION

17.35 – 19.45  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: Adamson, Neves

17.35 – 17.50 Göksel – Preservation Rhinoplasty through the open approach: an overview
17.50 – 18.00 Kosins – Why I open every tip to make it beautiful and when preservation makes it better
18.00 – 18.10 Toriumi –  Why my tips are still structural and my dorsum isn’t: my preservation journey
18.10 – 18.15 Q&A

18.15 – 18.40 PANEL: “What  I Preserve, When I Preserve and How”   
Indications to the right TIPS for  preservation techniques, understanding what is preserved and how – 5 min
DISCUSSANTS: Celik,  Kosins, Toriumi

18.15 – 18.20 East
18.20 – 18.25 Kovacevic
18.25 – 18.30 Most
18.30 – 18.35 Neves
18.35 – 18.40 Discussion

18.40 – 19.00  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 Heppt – Preservation of medial crura connecting fibres, alar perichondrium, scroll area, re-approximation of Pitanguy´s ligament
18.56 – 19.00 Neves – Tip ligaments restoring in open approach  

19.00 – 19.30  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, Sureyya

19.00 – 19.05 East –  Tip surgery with preservation concept
19.05 – 19.10 Kosins – Preservation of the Soft Tissue Envelope and Ligaments
19.10 – 19.15 Most – Advantages of external approach: Ability to perform external tip-plasty in conjunction with preservation
19.15 – 19.20 Gerbault – Use of LLC – SMAS connections to achieve a natural eversion of the lower lateral crura
19.20 – 19.25 Heppt – Cartilaginous tongue in groove with customized tip split for tip rotation and fixation
19.25 – 19.30 Robotti – Subperichondral-subperiosteal  dissection and the three point compartmentalization suture

19.30 – 19.45  Question-Time Panel ”Straight Question, Straight Answer”
INTERVIEWER: Robotti
PANELISTS: East, Göksel, Kosins, Kovacevic, Most

19.45 Adjourn

21.00  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 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 – 12.30  Masterclasses

07.00 – 08.00 CoboSurgical and Non-Surgical Management of the Thick Skinned Rhinoplasty Patient.
08.00 – 09.00 Sureyya – Structural Primary Open Rhinoplasty: How and Why it works
09.00 – 10.00 ZholtikovAesthetic analysis of the Nose. The importance of pre and intraop Measurements
10.30 – 11.30 Apaydin – Profile Alignment: planning the profile before surgery. Analysis, imaging, planning, measuring, making profile templates and using them
11.30 – 12.30 Calvert Diced Cartilage and Fascia Grafts
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12.00 – 14.00  LUNCH STATION AND EXHIBITS

Room B (Alabastro) – An Afternoon of Videos Exclusively

AFTERNOON SESSIONS

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

14.00 – 16.40 PRESERVATION and VARIATIONS and its Variants VIDEOS 
REVIEWERS: àWengen, Haack

14.00 – 14.30 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 Göksel – Open Preservation Rhinoplasty with Cottle Maneuver
14.55 – 15.20 Gerbault – Controlling the osteocartilaginous vault position during dorsal preservation procedures with sutures and grafts
15.20 – 15.45 Kosins – The Preservation Rhinoplasty – A Case of Total Preservation of STE, Dorsum and Tip
15.45 – 16.10 Most – Modified Let-Down Rhinoplasty via External Approach with Piezo
16.10 – 16.40 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

17.00 – 19.15 STRUCTURAL RHINOPLASTY  VIDEOS
REVIEWERS: Duron, Kuzanov

17.00 – 17.25  Rohrich – Bulbous asymmetric tip requiring rotation and complete tip reshaping
17.25 – 17.55 Heppt – Correction of boxy tip, Droopy nose, Broad nasal base, Hump
17.55 – 18.15 Apaydin –  Hump and Droopy tip in a Mediterranean patient
18.15 – 18.35 Foda – Open rhinoplasty in hump and underprojected tip
18.35 – 18.55 Calvert – Open rhinoplasty with major septal reconstruction
18.55 – 19.15  Zholtikov – Open Rhinoplasty in a Bulbous Tip nose

21.00  SOCIAL DINNER