Lesson 1Dorsal hump reduction manoeuvres: rasping, guarded osteotomy, component resection, preservation techniques (let-down/let-in)This section addresses dorsal hump reduction, comparing rasping, guarded osteotomy, and component resection with preservation techniques such as let-down and let-in, focusing on smooth dorsal lines and prevention of open roof or inverted-V deformity.
Preoperative dorsal profile analysisRasping versus guarded osteotomy useComponent dorsal hump resection stepsLet-down and let-in preservation conceptsAvoiding open roof and inverted-V deformityLesson 2Septoplasty operative steps: submucoperichondrial elevation, cartilage scoring, septal pocketing, extracorporeal septoplasty principlesThis section outlines stepwise septoplasty, emphasising submucoperichondrial elevation, cartilage scoring and reshaping, septal pocketing for grafts, and principles of extracorporeal septoplasty while preserving L-strut integrity and minimising mucosal injury.
Hemitransfixion and Killian incision choicesSubmucoperichondrial flap elevationCartilage scoring and controlled weakeningSeptal pocketing and graft stabilisationExtracorporeal septoplasty indications and stepsLesson 3Turbinate reduction techniques: submucosal resection, outfracture, radiofrequency or microdebrider-assisted reductionThis section reviews turbinate reduction options, including submucosal resection, outfracture, and radiofrequency or microdebrider-assisted techniques, emphasising mucosal preservation, bleeding control, and strategies to avoid empty nose syndrome.
Preoperative turbinate and airway assessmentSubmucosal resection indications and stepsOutfracture technique and stabilisationRadiofrequency and microdebrider methodsPreventing overresection and empty noseLesson 4Bony pyramid modification: lateral and medial osteotomies, greenstick vs complete, preventing and managing open roofThis section covers modification of the bony pyramid, including planning lateral and medial osteotomies, choosing greenstick versus complete fractures, controlling fracture lines, and preventing, recognising, and managing open roof and rocker deformities.
Preoperative analysis of bony vaultLateral osteotomy techniques and toolsMedial osteotomies and intermediate cutsGreenstick versus complete osteotomiesPrevention and repair of open roof deformityLesson 5Closed rhinoplasty techniques: endonasal suture techniques, limitations, and when to convert to openThis section reviews closed rhinoplasty approaches, detailing endonasal access, suture techniques for tip and dorsum, case selection, technical limitations, and criteria for safely converting to an open approach when exposure or control is inadequate.
Endonasal incision design and accessEndonasal tip suture techniquesEndonasal dorsal modification methodsRecognising limitations of closed approachIndications to convert to open rhinoplastyLesson 6Graft harvest and handling: septal cartilage harvest technique, septal preservation considerations, alternatives (conchal, costal)This section covers graft harvest and handling, detailing safe septal cartilage harvest with preservation of the L-strut, alternatives such as conchal and costal cartilage, and principles of carving, contouring, storage, and fixation to reduce warping.
Septal cartilage harvest and L-strut safetyConchal cartilage harvest techniquesCostal cartilage harvest and donor risksCarving and contouring to limit warpingGraft storage, orientation, and fixationLesson 7Open rhinoplasty exposure: transcolumellar and marginal incisions, soft tissue handling, and flap elevationThis section details open rhinoplasty exposure, including design of transcolumellar and marginal incisions, atraumatic soft tissue handling, flap elevation planes, and strategies to preserve vascularity, minimise scarring, and facilitate precise structural work.
Planning transcolumellar incision designMarginal incision placement and executionElevation planes and flap thickness controlProtecting vascularity and soft tissue envelopeClosure techniques to minimise visible scarsLesson 8Cartilage techniques for tip refinement: cephalic trim, medial and lateral crural sutures, interdomal and transdomal suturesThis section explains cartilage-based manoeuvres for tip refinement, focusing on cephalic trim planning, crural suture patterns, and dome-shaping strategies that balance definition, support, and airway preservation while minimising long-term deformities.
Planning and limits of cephalic trimMedial crural sutures for tip supportLateral crural sutures and contour controlInterdomal sutures for dome unificationTransdomal sutures for tip definitionLesson 9Nasal valve procedures: spreader graft placement, butterfly grafts, lateral crural strut grafts, alar batten graftsThis section focuses on nasal valve surgery, covering indications and planning for spreader grafts, butterfly grafts, lateral crural strut grafts, and alar batten grafts to restore internal and external valve competence without over-widening the dorsum or tip.
Assessment of internal and external nasal valvesSpreader graft sizing and fixation methodsButterfly graft indications and placementLateral crural strut graft design and pocketingAlar batten grafts for external valve collapseLesson 10Tip rotation and projection control: columellar strut graft, tongue-in-groove, tip sutures; effects on animationThis section explains operative control of tip rotation and projection using columellar strut grafts, tongue-in-groove manoeuvres, and targeted tip sutures, highlighting their biomechanical effects, sequencing, and impact on smile dynamics and animation.
Analysing baseline rotation and projectionColumellar strut graft design and fixationTongue-in-groove technique and variationsTip suture combinations for fine-tuningAssessing tip behaviour with facial animation
