Combine hybrid primary rhinoplasty with full rib-cartilage reconstruction of revision noses
The rib graft revision rhinoplasty course follows Enrico Robotti through six open operations — three hybrid primaries using push-down, let-down, bony-cap preservation and fusion sling, then three secondary or tertiary noses rebuilt with harvested, laminated costal cartilage, complete L-struts, extended lateral crural struts and SPF-SPLF dorsal constructs.
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6complete operative cases
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21h+operative video
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3rib-graft revisions
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Unlimitedcourse access
The programme
Hybrid philosophy in primary noses
Three women aged 27 to 47 present humps, asymmetry, bulbous or drooping tips and septal deviation. Dr. Robotti chooses between preservation and structural manoeuvres patient by patient, so the cases show judgement as much as technique.
Dorsal lowering & bony-cap handling
Modified dorsal split, high-strip reduction, cartilaginous push-down and full let-down are performed with partial preservation of the bony cap. Burr and piezoelectric osteoplasty refine the dorsal surface, illustrating how powered instruments complement preservation principles.
Septal dissection, compartments & airway work
Sublaminar septal dissection, subperichondrial and subperiosteal planes and the three-point compartmentalization technique are shown in detail. Septoplasty, turbinate management and piezo turbinoplasty address the functional complaints present in several of the patients.
Structural tip control
Tip work includes septal extension grafts, the septal fusion sling, lateral crural steal and transposition, slide-under and turn-under manoeuvres and dome sutures. Columellar struts, alar wedges, diced cartilage and contour grafts finish the primary cases.
Rib harvest and lamination in the rib graft revision rhinoplasty course
Costal cartilage is harvested, carved and laminated with an emphasis on reconstruction that avoids unnecessary graft bulk. Complete L-strut rebuilding, extended spreaders and vertical-element fixation restore support in noses weakened by previous surgery.
Secondary, tertiary & post-septoplasty reconstruction
A young man with saddling, open roof and pollybeak, a woman with overrotation and alar retraction, and a man with tip drop after Cottle septoplasty are reconstructed. SPLF dorsal grafts, perichondrium grafts, rib plaster and Spare Roof Type B reduction complete these demanding cases.
Who it’s for
- Revision rhinoplasty surgeons watch costal cartilage taken from harvest to final dorsal contour
- Facial plastic and ENT surgeons see preservation and structural principles blended in primary noses
- Plastic surgeons study L-strut reconstruction, septal lengthening and lateral crural rebuilding
- Residents and fellows follow six complete cases with narrated decision-making throughout
The consult
How is the course split between primary and revision work?
Evenly — three primary hybrid rhinoplasties come first, followed by a secondary case, a tertiary case and a nose operated after earlier septoplasty, all three reconstructed with rib cartilage.
Is this different from Robotti’s earlier Rhinocraft release?
This edition puts much more weight on rib grafting and revision surgery, giving half of its cases to reconstruction of previously operated noses rather than focusing mainly on primary hybrid work.
Are piezo and powered instruments used?
Yes — piezoelectric osteotomies, burr osteoplasty, powered instrumentation and piezo turbinoplasty appear across the cases, used selectively alongside conventional techniques.
Can these videos replace hands-on rib harvesting training?
No — they offer detailed operative exposure, but costal cartilage harvest and complex reconstruction should be learned under supervision within your own training and credentialing framework.
Will I have to wait for access?
No waiting — the six cases unlock right after checkout and remain yours for as long as you need them.
Do I get CME credit or a certificate?
No. Derma Academy provides the course files only — no CME or CE credits, MOC points or certificates of completion are included.
The spec label
| Format | HD operative videos with SRT subtitles — 6 cases |
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| Listed duration | More than 21 hours · released September 2026 |
| Faculty | Enrico Robotti, MD |
| Level | Advanced primary and revision open rhinoplasty |
| Techniques | Push-down · let-down · fusion sling · rib L-strut · SPF-SPLF constructs |
| Training models | Live patient surgery · narrated operative footage |
| Discipline | Plastic Surgery · Rhinoplasty |
| Delivery | Instant access · unlimited access in time |



