By Enrico Robotti, MD

Join Dr. Robotti in the operating room in HD connection in this unique two-volume video series exclusively dedicated to secondary rhinoplasty with finesse rib grafting techniques.

This video series thoroughly addresses the techniques, details, subtleties, and pitfalls of using rib in secondary cases, including the current state-of-the-art reconstruction of the dorsum with Dr. Robotti’s innovative techniques of SPF-SPLF grafts as well as “rib cartilage paste.”

Secondary rhinoplasty is a complex surgery which requires dedication and a long learning curve. This video series provides viewers with a clear algorithm, flexibility and strategy in intraoperative choices, attention to detail, and mastery of numerous tips and tricks. Each case includes full preoperative discussion with the proposed surgical plan, comprehensive demonstration of dissection and step-by-step surgical techniques, and final review including postoperative dressings.

The use of contemporary instrumentation, combining piezo and power tools is extensively covered. In various cases showing different deformities and different skin quality, the specific techniques for rib harvesting with proper attention to the donor site, rib shaping and laminating, varying septoplasties and L-strut septal reconstruction, combining rib grafting with residual available septum, piezo-turbinoplasty, reconstruction of the dorsal plateau and transosseous sutures, dorsal contouring, combined use of perichondrium, rectus fascia, and rib laminations, as well as the different modalities of tip reconstruction is significantly covered. The importance of using finely crafted rib grafts and avoiding unnecessary bulk is clearly demonstrated in all cases. The techniques for obtaining a proper airway as well as better aesthetics is also extensively covered.

Volume 1
4 Cases With Over 13 Hours of Operative Video!

Case 1: Secondary rhinoseptoplasty with finesse rib grafting in 29-year-old female patient with inverted-V deformity, tip overshortening, pinching and alar retraction, septal and tip deviation, thick skin

Case 2: Secondary rhinoseptoplasty with finesse rib grafting in 25-year-old male patient in sequelae of previous trauma and rhinoseptoplasty: severely crooked nose, bony and septal deviation, bulbous and drooping tip

Case 3: Tertiary rhinoseptoplasty with finesse rib grafting in 32-year-old female patient: significant overrotation and overshortening, polly beak, alar retraction, asymmetric osteotomies, tip deviation, nasal base asymmetry, thick skin

Case 4: Secondary rhinoseptoplasty with finesse rib grafting in 56-year-old female patient: complete open roof, “ball” and pinched tip, alar retraction, saddling, tip overrotation and hyperprojection, infratip excess, distal deviation

Volume 2
4 Cases With Over 15 Hours of Operative Video!

Case 1: Secondary rhinoseptoplasty with finesse rib grafting in 35-year-old female patient: irregular dorsum, inverted-V deformity, polly beak, alar retraction, nasal base asymmetry, residual septal deviation, thin skin

Case 2: Secondary rhinoseptoplasty with finesse rib grafting in 27-year-old male patient: crooked, saddled, and overshortened/overrotated nose; with asymmetric osteotomies; dorsal asymmetries; residual septal deviation; thick skin

Case 3: Tertiary rhinoseptoplasty with finesse rib grafting in 45-year-old female patient: deviated nose, open roof, polly beak, asymmetric osteotomies, asymmetric and destructured tip

Case 4: Secondary rhinoseptoplasty with finesse rib grafting in 42-year-old male patient: sequelae of columellar necrosis with secondary healing and skin loss, verticalized nasal bones, asymmetric tip, nasal base asymmetry, infratip excess