-
Views
-
Cite
Cite
Daniel J Gould, Commentary on: Step-Specific Simulation: The Utility of 3D Printing for the Fabrication of a Low-Cost, Learning Needs–Based Rhinoplasty Simulator, Aesthetic Surgery Journal, Volume 40, Issue 6, June 2020, Pages NP346–NP347, https://doi.org/10.1093/asj/sjaa060
Close - Share Icon Share
Extract
The authors of this study should be commended for their attempt to improve the quality of outcomes and training in rhinoplasty.1 Rhinoplasty is undoubtedly one of the most difficult surgeries to master within the specialty, and to make matters more complicated it is also one of the least commonly encountered procedures in training. With the exception of ASAPS-accredited fellowships, where exposure to this surgery is common and is in fact mandated, most residency training programs are limited to traumatic and congenital cases. This problem exists because rhinoplasty is often performed in the community and in these settings patients are typically paying cash with an expectation of care. Despite the hurdles to rhinoplasty training, a model such as the one designed here is a good start toward exposing young surgeons to some key principles.
Many would argue that good rhinoplasty starts with nasal analysis. Trainees can certainly read any number of excellent texts, such as those by Daniel,2,3 Sheen and Sheen,4 or the recent work by Toriumi,5 in order to see images of patients with diagnosable deficiencies and then to follow along the surgical maneuvers that were performed to fix these. In any setting, trainees can utilize their aesthetic eye first, but we all know the eye doesn’t see what the mind doesn’t know.6 Next is the planning that goes into the case; contemplating how the different maneuvers will occur in sequence is key, but also knowing how each move will subsequently affect the result or the next few choices in order is critical to the process of obtaining reproducible and good results. The model these authors propose offers several opportunities: it will allow surgeons to preoperatively plan their cartilaginous changes as well as their osteotomies, and to better visualize the underlying pathology. This will no doubt allow for improved planning and understanding of how the photographs correlate with the structural anatomy.
