PROGRAM MARCH 26

MORNING SESSIONS

06.30 – 06.55 COFFEE STATION AND REGISTRATION

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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 Davis  – The importance of proper restructuring in the thick-skinned nose
07.15 – 07.23 Kosins – Controlling the Thick Soft Tissue Envelope: Use of Ultrasound and  Accutane
07.23 – 07.31 Cobo – Integrated approach to the thick skin rhinoplasty 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 – 09.05 ■ 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 Most-  Asian Rhinoplasty
08.49 – 08.53 Cobo  – Mestizo nose rhinoplasty
08.53 – 08.58 Kosins  – Septal extension graft and tensioning for the Hispanic nose
08.58 – 09.05 Q&A

09.05 – 19.55 Session 14:  More thoughts on Preservation: Why it is not so easy.. 

 – Understanding some further key  concepts in preservation to avoid problems in your practice
– Why is not easy and why it is worth trying
 – The learning curve

CHAIRS: Cobo, Haack

09.05– 09.20  Göksel – Blocking points and straightening maneuvers in preservation rhinoplasty
09.20 – 09.35 Neves– Avoiding drawbacks and stigmata  in preservation rhinoplasty
09.35-09.55 The learning curve in preservation rhinoplasty explained (10 min per speaker)

1. 09.35-09.45 Kosins
2. 09.45-09.55 Kovacevic

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09.55 – 10.20 COFFEE BREAK AND EXHIBITS

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10.20 – 10.50 ■ Judgement Day  Boxing-Ring Panel:  Adopt Preservation, Stay Safe and Structural, or use Shades of Grey?   “The importance of being Earnest”

• Is a Structural Surgeon a destroyer or a rebuilder?
• Is a Preservation Surgeon really “preserving”?
• Is there a middle ground?

(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: Rohrich, Toriumi
__PRESERVE: East, Göksel, Kosins
__RECONSTRUCT: Apaydin, Cerkes, Gubisch

10.50-11.10  ■ Toriumi – Special “Off-Topic”Presentation – Managing the Cleft Lip Nasal Deformity

11.10-11.20  ■ Cervelli – Special “Off-Topic” Presentation – Virtual Rhinoplasty in the Roman Emperors of the Julia-Claudian Dynasty

11.20 – 12.00  Special “Off- Competition Presentation ”
                         Scheibel – Interlocked SEG – Maximum stability

11.20 – 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

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12.00 – 14.00  LUNCH STATION AND EXHIBITS

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12.00-12.30  ■ Guyuron – Special Keynote Online Lecture   – Rhinoplasty Tips and Traps:  40 years of learning”

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

13.00 – 18.25 Session 15 – 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

13.00 – 14.00 PART 1 ■ Preventing secondary rhinoplasty
(Avoiding preop errors in assessment and intraop errors on technique in the primary rhinoplasty)
CHAIRS: Celik, Foda

13.00 – 13.12 Rohrich – Why primary rhinoplasty fails (and on the importance of closing dead space)
13.12 – 13.20 Adamson  The Failed Rhinoplasty Due to Malposition of the Lower Lateral Crus
13.20 – 13.28 Haack – What I did in the last 5 years to avoid revisions in tip surgery
13.28 – 13.36 Göksel – Reducing the risks in primary rhinoplasty so as to reduce complications and make them manageable if they occur
13.36 – 13.44 Celik –  Preventing Airway problems post rhinoplasty
13.44 – 13.52 Cabbarzade – A list of things that shouldn’t be done in rhinoplasty
13.52 – 14.00 Q&A

14.00 – 14.20 ■ Toriumi – Special Video-presentation – Costal cartilage structural grafting: improving outcomes

14.20 – 15.50 PART 2 ■ Performing secondary rhinoplasty
(The key principles and techniques in secondary rhinoplasty)
CHAIRS: Gubisch, Sureyya

14.20 – 14.35 Göksel – Tips in revision rhinoplasty
14.35 – 14.40 Cerkes – Structural Reconstruction in secondary rhinoplasty
14.40 – 15.00 Gubisch – Use  of rib and ear cartilage in modern rhinoplasty
15.00 – 15.10 Davis – Treatment of Post-Surgical Alar Retraction with Articulated Alar Rim Grafts
15.10 – 15.18 Calvert – DCF (Diced Cartilage in Fascia) grafts
15.18 – 15.26 Bussi – Long-term survival of diced cartilage for dorsal  contouring: histological findings
15.26– 15.34 Toriumi – Composite Grafts: when and how
15.34 – 15.42 Gerbault – Management of bone defects  in secondary rhinoplasty
15.42 – 15.50 Q&A

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16.00 – 17.30 COFFEE STATION

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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

15.50 – 16.45  Section 1 – SECONDARY DORSUM and TIP
REVIEWERS: Calvert, Cerkes

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:
__1 Calvert
__2 Göksel (by hairline incision)
__3 Robotti
16.17 – 16.21 Harvesting rectus fascia – 2 min Videoflashes:
__1 Cerkes
__2 Robotti
16.21 – 16.25 Zholtikov – Composite dorsal augmentation
16.25 – 16.30 Rohrich – Why Fresh Frozen Rib Grafts are Better and how to use them to restore the secondary DAL
16.30 – 16.34 Paun – Frozen cadaveric rib cartilage in revision rhinoplasty
16.34 – 16.38 Celik – Use of conchal cartilage and retroauricular soft tissues in secondary rhinoplasty  for dorsum reconstruction   – combination with   Dorsally extended spreader grafts
16.38 – 16.41 Robotti –Septal T push-up with rib spreaders for neo L strut-based dorsal augmentation
16.41 – 16.45 Gubisch – Problems in using DCF and how to overcome them

SECONDARY TIP
16.45 – 16.49 Toriumi – Costal cartilage tip reconstruction
16.49 – 16.53 Cobo – Structural grafting in the nasal tip without using rib cartilage
16.53 – 16.57 Gubisch  – What to do after overresection of LLC and tips on the “Bending Technique”
16.57 – 17.01  Cerkes – Tip tripod reconstruction with strut grafts from the rib
17.01 – 17.05 Zholtikov – Lateral crura modification with lateral crura strut grafts
17.05 – 17.09 Rohrich – Role of scar tissue grafts in secondary tip reshaping and dead space closure
17.09 – 17.13 Toriumi – Premaxillary graft for tip projection
17.13 – 17.17 Apaydin – Shield grafts in revision
17.17 – 17.21 Most – Tip/alar reconstruction with use of lateral crural struts and lateral crural replacement

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17.21 –18.18   Section 2 – RIB and EAR donor sites
REVIEWERS: Gubisch, Robotti

17.21 – 17.39 RIB   a) harvesting   
(3 min videos per speaker followed by 5 min discussion at end of group)

1. 1. 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. Robotti – Inframammary fold incision and full thickness harvesting      

17.39 – 17.54 RIB   b) segmentation-fabrication 
(3 min videos per speaker followed by 5 min discussion at end of group)

1. 1. 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. Most – Oblique rib cutting to avoid warping
      5. Haug – The two-piece rib cartilage L span graft fabrication

17.55 – 18.20 EAR  harvesting/fabrication 

17.55 – 18.05 Foda –  Specific techniques on my preferred use of ear cartilage (videos)
18.05 – 18.20 (3 min videos per speaker)

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

18.20 – 18.35 ■ Robotti – Special Topic – The SPF-SPLF graft: optimising outcomes for tailored dorsum contouring-augmentation

18.35 – 18.55 ■ Panel “Challenging Revisions: what would you do for this case?”
MODERATOR: Davis, Gubisch
PANELIST: Cerkes, Robotti, Toriumi, Wurm, Zholtikov

18.55 – 19.25 ■  Camouflage and Finishing Touches in primary and secondary rhinoplasty – personal preferences –  Videopanel
(3 min videos)
REVIEWERS: Kovacevic, Zholtikov

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

19.25 – 19.30 Toriumi – Special Topic: M.I.S.T.A.: Microfat infused soft tissue augmentation for the nasal dorsum

19.30  Wrap-up, Farewell and  Adjourn