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					                                                                                                     December 2006




EAFPS
  The European Academy of Facial Plastic Surgery                                                                   www.eafps.org
                                                                               EAFPS 2005 Annual Conference
Dear Colleagues and Friends,                                                   Long-Term Results in Nasal and Facial Plastic
In my last Presidential Address I said that the European Acad-                 Surgery. Florence, Italy
emy is in good shape and steadily growing. Now I can even be                   September 29 - October 1, 2005
more positive about our Academy. We have now over 600 pay-                     David’s genitals are tea towels and mouse mats now, but spend
ing members and as part of the Int. Federation of Facial Plastic               an afternoon at Uffizi and go on to the see the frescoed Medici
Surgery Societies (IFFPSS) we are second largest after the USA.                Chapel and you can almost taste the flamboyant confidence of
Still there is a lot of work to do! I refer to the report of our annual        the 16th century, when this city rewrote the rules of Western art
”brainstorm” meeting of the Executive Board and Committee                      and culture. The Tuscan capital hosted last year’s conference of
Chairmen in Stresa April 22-23. Pietro Palma and Ralf Siegert                  the European Academy of Facial Plastic Surgery. Florence of-
together with the committee members are the driving forces. Our                fered participants and partners the opportunity to gather in a cul-
website is in the process of renewal and looks already great.                  tural and charming site. Life is sweet in Florence and anywhere
Werner Heppt has made the Video/DVD library work with the                      you look, the eye alights on beauty and harmony.
first DVD’s on facial plastic surgical procedures. The EAFPS
Annual Meeting in Dublin was a great success. Peter Lohuis and                 The conference president was
Hade Vuyk edited an excellent                                                  Pietro Palma and he has to be
“European“ book on Facial                                                      congratulated for his extraor-
plastic and Reconstructive                                                     dinary effort in organizing a
Surgery, with mainly Euro-                                                     comprehensive and enriching
pean contributors. Congratu-                                                   programme in this mag-
lations! The Facial Plastic Sur-                                               nificent city. This hugely suc-
gery monographs are on the                                                     cessful conference attracted
rails again, and on time with a                                                207 participants and 60 fac-
reshuffled Editorial board and                                                 ulty members from 30 differ-
renewed “overcoat” . Often I                                                   ent countries all around the
have been asked, what are the Gilbert Nolst-Trenité and Pietro Palma           world. Over three days, the
benefits of the members of the                                                 most renowned speakers of-
EAFPS. Well, number one, there is a considerable financial bene-               fered updates in this chal-
fit. Many international courses and meetings are under the aus-                lenging field of nasal and fa-
pices of the EAFPS and give a 10% reduction in fee. Further-                   cial plastic surgery, focusing
more there is a considerable reduction for the Monographs and                  on long-term results. The
the Archives. Beside the financial benefits there is the certifica-            Programme Committee was
tion process through the Int. Federation of FPSS. Once passed                  formed by Pietro Palma
the American Board Exam and then finishing the certification                   (Chairman), Abel-Jan Tasman
process with 100 FPS procedures in two years it will benefit in                (Co-chairman), Lydia Badia,
every discussion with a variety of surgical disciplines regarding              Peter Lohuis, Giovanni Botti
our qualification to perform facial plastic surgery. Education is              and Sebastiano Sciuto. The
the key for the future of our Academy. So we need good Teach-                  EAFPS Executive Board, Gil-
ing Centres for our fellows, high quality courses and not only on              bert Nolst Trenité (President),
Rhinoplasty but on the complete scope of facial plastic and re-                Pietro Palma (General Secre- Members of the programme committe:
constructive surgery. Still, several countries should be better                tary) and Ralf Siegert Lydia Badia, Pietro Palma,
represented in the EAFPS, such as France, Spain and Scandi-                    (Treasurer) welcomed mem- Abel-Jan Tasman
navian countries. New countries with their representatives are                 bers and non members to a
embraced from Eastern Europe. Dear friends, the European                       perfect blend of scientific topics and social activities.
Academy is in good health!                                                                                                    Lydia Badia

Yours sincerely,                                                                                           Lower lid blepharoplasty,
Gilbert J Nolst Trenite                                                                                    the American perspective
President
                             content




                                       Report on the EAFPS 2005 Annual Conference, Florence         1      Keith LaFerriere (The Role of Fat
                                       Treasurer Report                                             4
                                       EAFPS Media Library                                          5      Repositioning and Fat Trans-
                                       EAFPS Fellowship Committee Report                            5      plantation in Lower Blepharoplasty.
                                       EAFPS Brainstorming Meeting Stresa 2006                      6      A Long Term Experience) described
                                       EAFPS Certification Committtee Report                        7      t h e e v o lu t io n o f lo we r l id
                                       Report on the EAFPS 2006 Annual Conference, Dublin           7
                                                                                                           blepharoplasty from an „ablative“
       Editor: Abel-Jan Tasman
procedure resecting skin, muscle and fat to a more sculpting
procedure, preserving and repositioning fat. In the last 10
years many publications described the preservation and repo-
sitioning of fat, especially in the double-convexity deformity.
The lateral fat pad cannot be stretched as well as the medial
and middle pad and should be resected. The repositioned fat
pads may be secured with a transcutaneous stitch for several
days.

Tom Wang (Safe transconjunctival lower lid blepharoplasty
with long-term results) stressed that a safe transconjunctival
approach is to stay posterior to the orbital septum. A low
transconjunctival Incision leads the surgeon directly into the
orbital fat. This approach reduces the risk of lower lid retrac-
tion, as the skin, muscle and septum are not dissected. The
inferior oblique muscle is more at risk, compared to a presep-
tal dissection and should therefore be visualized at all times.
The lower eyelid skin may be routinely resurfaced in con-
junction with a transconjunctival lower blepharoplasty.
Vito Quatela (Inferior blepharoplasty pearls) presented an
algorithm for lower lid blepharoplasty stressing the role of a
midfacial lift, allowing considerably more skin to be re-
moved (up to 10-14 mm). As a rule, however, skin and mus-
cle should be spared.

Peter Adamson (Transconjunctival Blepharoplasty) For
transconjunctival lower eyelid blepharoplasty the incision
should be placed half way between the tarsus and the inferior
conjunctival fold (i.e. about 4 mm caudal to the tarsal plate)     Patient before and one year after neck, lower and mid-face lift with rhino-
and stay 3-4 mm away from the medial punctum.                      plasty: The patient wished to improve her heavy neck, her ugly nose and her
                                                                   deep tear troughs. Surgery and photography by Giovanni Botti.
Auricular reconstruction
Stephen Park (Algorithms for Auricular Reconstruction) For         lower periorbital area (tear trough, malar bag, naso-labial
reconstruction of the auricle, Park prefers a wedge or             groove, etc) is granted by the newest mid-face lift techniques.
star repair for defects up to 20 mm. as the size discrepancy       They call for a sub periosteal or suborbicular undermining
remains inconspicuous. Larger defects often require septal or      of that region, in particular of the malar and subpalpebral ar-
costal cartilage, covered with a temporoparietal fascia flap       eas, followed by a
and a skin graft. Free skin grafts are ideal for skin              whole-thickness
only defects of the auricle, even if small areas                   uplifting of the
of perichondrium remain dehiscent.                                 soft tissues ac-
Ralf Siegert (Refinements in auricular reconstruction)             cording to bidirec-
described his method of auricular reconstruction as a 3 step       tional,     mostly
procedure that includes harvesting of rib cartilage and            vertical vectors.    Cemal Cingi, Charles East, Abel-Jan Tasman and
construction of the framework in the 1st step, elevation the                                Koen Ingels
new auricle in the 2nd step and minor refinements in the 3rd       Peter Adamson's
step. In appropriate cases it can be combined with tym-            points on the controversy of a short flap vs. a deep plane
panoplasty to correct the concomitant atresia. As an alterna-      facelift surgery (the short flap being ~3 cm with an S-incision
tive to autogenous cartilage alloplasts like Medpore can be an     in the supra-SMAS plane; the deep plane dissection sub-
option, but its longterm stability still has to be proven.         SMAS and subplatysma in the face and neck) were that the
                                                                   short flap technique offers a “reasonable” effect, is safe and
Facelift                                                           fast. It is suited for the younger patient who wants minimal
Giovanni Botti stated that blind subcutaneous dissection is        changes and is satisfied with a more subtle jaw line
safe in facelift surgery, even if a correct SMAS treatment is      improvement. For older patients with greater deformity, how-
still necessary to obtain a                                        ever, it is better to elevate a short skin flap (~3cm) then ele-
great and long lasting result.                                     vate under the platysma
Loré’s fascia, just anterior                                       and SMAS. This helps to
to the earlobe, is a                                               improve midface and
very good anchoring point                                          malar ptosis as well. The
for the SMAS flap. Also the                                        advantage is that these
earlobe should be fixated to                                       procedure and there is
deep tissue planes in order                                        twice as much lift
to prevent a satyr ear de-                                         achieved. Dissecting from
formity. Botti confirmed                                           above to below will allow
that the most effective solu- Hesham Saleh, Archana Vats           the surgeon to stay above
tion to the problems of the and Regan Thomas                       the zygomaticus major Ted Cook and Julian Rowe-Jones

2
muscle preventing inadvertent injury to the facial nerve.              mately 2 mm cranial to the medial canthus. Through a upper
Fixation of SMAS and platysma with Vicryl 3-0 sutures is               eyelid blepharoplasty approach the lateral retinaculum is dis-
sufficient.                                                            sected from its tubercle and attached cranial at the perio-
                                                                       steum.
Scar Revision
Regan Thomas (Facial Scars) talked about time tested prin-             Mario Pelle Ceravolo (The treatment of the cervicomental
ciples of scar management. Preparing the patient to accept             angle in rhytidectomy) demonstrated how various shapes of
the improvement of the scar and not the disappearance is es-           chin implants correct the pre-jowl sulcus, a soft tissue de-
sential. The Z-Plasty is still a „Workhorse“, especially as a          pression over the mandible, between the chin and the ptotic
multiple-Z, e.g. in trap-door scars. Relaxed Skin Tension              buccal tissues.
Lines should be respected when excising triangles in a W-
Plasty. The components in a W-plasty should be approxi-
mately 5-7 mm. Dermabrasion is routinely used as a second              Tying it all together:
stage following scar revision after 6-8 weeks.                         total facial rejuvenation
                                                                       This round table chaired by Tom Wang summarised the ses-
“All about fat”                                                        sions on facial rejuvenation. Participants were Peter
Nabil Fuleihan suggested to treat the cheek fat-pad as a sepa-         Adamson, Giovanni Botti, Ted Cook, Jaime Fandino, Nabil
rate entity. In patients with little facial fat, isolated skin lift-   Fuleihan, Gonzales-Romero, Russell Kridel, Keith
ing may suffice. Use 3-4 prolene 3-0 or 4-0 sutures through            LaFerriere, Craig Murakami, Vito Quatela and Regan
cheek fat-pad after release of periostium (transconjunctival           Thomas.
approach) to temporal fascia. In a tear trough deformity
dissection should be in supraperiostal plane as the deformity          The endoscopic technique was preferred for forehead lifting
is only shifted if dissection is subperiostal.                         by all panellists with the exception of Peter Adamson who
                                                                       used both the open and endoscopic technique. The transcon-
Russell Kridel emphasised that it is essential to treat the            junctival and external technique were both used in lower lid
hollow-cheek deformity with sub-malar implants placed                  blepharoplasty by all panellists. For facelifting nobody re-
transorally. Keith LaFerriere (The Transorbital subperiosteal          sected skin only and three participants used the deep plane
midface lift) Showed his 10 first consecutive cases and                technique on a regular basis.
stressed that the reposition of a ptotic malar fat pad is the key
element for midface rejuvenation. The advantages are a di-             Thread lifts and string lifts are based on a suspension of the
rect vertical elevation of the midface tissues without widen-          skin with Gore-Tex or polyamide threads under local
ing of the face as it is seen with the trans-temporal approach         anaesthesia. There is a huge interest in thread lifts and the
in which the origins of the zygomatic major and minor mus-             procedures is massively pushed by the manufacturers in the
cles are relocated in a superiorlateral direction. The inferior        U.S. Very expensive courses ($ 2000 to $ 3000) are a
dissection of the periosteum is to the level of the nasal ala, as      prerequisite before the string is offered. Peter Adamson
opposed to the dental roots. That is also the level of incision        warned that considering an extrusion rate of 3-12% of Gore-
of the periosteum. The anchoring of the lift is at the level of        Tex in the nasal dorsum, the string technique has a higher
the lateral canthus to a periosteal cuff rather than the deep          probability than desirable of extrusion, tethering and loss of
temporal fascia.                                                       correction. Nabil Fuleihan expected threads to be improved
                                                                       and suggested that we should be open-minded. Vito Quatela
Tom Wang (Rationale and results for endoscopic midfacelift)            also thought that the string technique will stay, for various
reminded the participants that the frontal branch of the facial        reasons, such as the pressure by hospital administrations.
nerve crosses the zygomatic arch in the middle third. The dis-         Threads may be the answer for young patients who want a
section for a midface lift should therefore be on the anterior         minimal lifting of fat. There were no positive answers to the
third of the zygoma. Through a mall sagittal sublabial inci-           question whether any participants had seen a truly good
sion the infraorbital periosteum is elevated and a needle is           result.
passed through the skin at desired elevetion points. Vicryl 2-
0 may be used for suspension. This technique is safe even              The LifeStyle Lift was described as a Current fad in the
though the effect may be limited in patients with severe               USA. The technique is based on a short–flap lift or S-lift.
ptosis and a pronounced nasolabial groove. In very thin pa-            The low cost for the patient ($ 3800) includes a $ 750 remu-
tients with a poor bony structure, submalar implants.should            neration for the surgeon. The Principle is franchising without
be considered, rather than a midfacelift                               structured pre-operative or post-operative care. The LifeStyle
                                                                       Lift was found to fill a gap and meet a demand in the popula-
Based on 656 cases of endoscopic brow and midface lift,                tion: it is attractive for young plastic surgeons who want to
Vito Quatela emphasised that the endoscopic brow lift causes           stay in practice and accept to be franchised. Tom Wang men-
less elevation of the hairline compared to a subgaleal dissec-         tioned that Doctors are guaranteed a substantial income if
tion due to rigidity of periosteum. The dissection should be           they sign up. Even though the panellists were unanimously
extended down to the zygomatic arch, then stay under the pe-           critical towards the LifeStyle Lift, no one had seen bad re-
riosteum and curve around the zygomatic arch. A periostal              sults. It was unclear what was the position of the American
strip of approximately 5x15 mm should be left adjacent to              College of Surgeons.
the lateral retinacular attachment, which was also said by
Tom Wang. Tension on the skin should be avoided and ele-               The final question which was very interesting for the
vation should be due to release.                                       European Otorhinolaryngologists was how to jump from
According to Keith LaFerriere (Lateral retinacular repo-               nasal plastic surgery to facial rejuvenation surgery. Russell
sitioning canthoplasty) the lateral canthus should be approxi-         Kridel suggested to visit others and watch them in the

3
      operating theatre instead of merely attending a course or                                                    3rd, 2006 to increase our membership fees starting in 2007 for
      lecture. Keith LaFerriere proposed to start “soft” (skin care                                                full members from 90 €/a to 135 €/a, for Affiliate Member
      e.g.) then move on to more invasive procedures. Craig                                                        (colleagues from East European countries and Residents in
      Murakami found teaming up with a dermatologist helpful as                                                    Training) from 50 €/a to 70 €/a and no change for Senior
      a skin cancer patient may be interested in rejuvenation and                                                  Members.
      the scalpel may help where peelings fail.
                                                                                                                   In addition and without our influence the subscription of
                                                                                                                   Facial Plastic Surgery has been increased by Thieme from 90
                                                                                        Abel-Jan Tasman
                                                                                                                   €/a to 95 €/a. Nevertheless we still have a high reduction for
                                                                                                                   our members because the regular price would be 266 €/a.
      Treasurer Report 2005
      Financial Report                                                                                             Activities until August 2006
      My financial report for 2005 has been accepted by the                                                        After we have legalized the EAFPS as a non-profit
      General Assembly in Dublin on September 3rd, 2006. It has                                                    organization we have modified the financial management by
      also passed the tax audit of the German Inland Revenue                                                       establishing an official EAFPS-office based in Germany. It
      responsible for the acknowledgement of our status as a non-                                                  runs under my supervision by our part-time secretary Gabi
      profit organization. It was counterbalanced and our activities                                               Behncke. In the beginning it took some time to reorganize
      including the fellowship program and the meetings in                                                         the membership list, the main data base, the accounts,
      Florence and Stresa could be financed. Right before the                                                      transfer systems and cooperation with the publishers of
      Congress in Dublin our current balance was 156.714,45 €.                                                     Facial Plastic Surgery and Archives of Facial Plastic Surgery.
      Nevertheless, for the future we have to face the following                                                   Many individual contacts, queries and also monitions with
      facts and developments:                                                                                      and to our members had to be sent, but now we could
                                                                                                                   establish a well functioning routine organization for all
      • Our membership-fees are very moderate compared to our                                                      aspects of membership, finances and subscriptions.
        activities and to other comparable international
        organizations.                                                                                             We have opened two official EAFPS accounts, a current and
                                                                                                                   a capital account with higher interest rates paid to us. Also
      • The benefits for our members even from a purely                                                            we have set up contracts with the main credit card companies
        economical perspective are very high: All of us receive                                                    so that we can charge the membership and subscription fees
        10 % reduction on courses under the EAFPS-auspices and                                                     directly to our members credit card if they want us to.
        a 42% to 65 % (!) reduction on subscription of Archives                                                    Unfortunately this does cost us much more than direct
        of Facial Plastic Surgery or Facial Plastic Surgery                                                        transfers actively done by our members, but we thought to
        respectively.                                                                                              offer this easy way of payment for the convenience of our
      • Our congress fees are rather high, especially for younger                                                  members.
        colleagues and colleagues from certain countries, in                                                       With plenty of individualized circulation letters, that all of
        particular some East European countries.                                                                   you should have received, we started a complete membership
      • In the future we want and should increase several                                                          renewal action. Most of you have answered immediately, but
        activities (see below) which are for the benefit for our                                                   some of our former members have not answered at all - not
        members.                                                                                                   even after three letters and contacting their responsible
                                                                                                                   national delegate. There are also a few colleagues who have
      Therefore it was proposed by the executive board and                                                         not paid their fees even after three monitions. Of course these
      approved by the General Assembly in Dublin at September                                                      had to be eliminated from membership list and our official
                                                                                                                   members list in the internet.
                                                        1111 11
                                                     111                                                           Others forgot neccessary information like mode of requested
New EAFPS members 2005




                                                   11                                Germany        Azerbaijan
                                                 11                      27
                                               11                                    Italy          Belgium
                                                                                                                   payments, membership category or subscriptions they want.
                                              2
                                          2                                          U.K.           Croatia
                                  2
                                 2
                                                                                     Netherlands    Denmark        My secretary had up to six individual mailings or phone calls
                                                                                                    Finland
                                2
                                                                                     Greece
                                                                                     Poland         France
                                                                                                                   to some of our members to receive these data. By now most
                                  3                                                  Portugal       Hungary        of these difficulties could be solved and - since we will not
                                 3                                                   Russia
                                                                                     Switzerland
                                                                                                    Israel
                                                                                                    Kuwait
                                                                                                                   ask for membership renewal any more, but assume that
                                 3
                                 3
                                                                                     Turkey         Lebanon        everyone wants to continue his or her membership and
                                                                                     Austria
                                      4
                                                                              23
                                                                                     Bulgaria
                                                                                                    Macedonia
                                                                                                    Romania
                                                                                                                   subscriptions until we receive different information - it will
                                          4                                          Iran           Saudi Arabia   probably work much smoother in the future.
                                                                                     Spain          Slovenia
                                                  10                                 Ukraine                       Everyone who has paid his / her fees received a certificate
                                                        34
                                                                                                                   together with the receipt. Since the responses to these
                                         5 4                                                                       certificates have been very positive, we will continue to do so
EAFPS members by country




                                        5 4 3
                                       5 4
                                     5
                                   6 7
                                                                       129
                                                                                                                   in the future.
                                  6                                                 Germany        Ireland
                                86
                            11
                              11                                                    U.K
                                                                                    Italy
                                                                                                   Sweden
                                                                                                   Lebanon
                                                                                                                   We also asked all our national delegates to look out for
                           12                                                       Netherlands    Poland          colleagues in their own country who might be interested to
                                                                                    Switzerland    Norway
                           15
                                                                                    Greece         Israel          join us and to give us their names and addresses. Hereupon
                           19                                                                      Iran
                                                                                    Austria
                                                                                    Belgium        Russia
                                                                                                                   some of our national delegates even send us long lists. We
                           20
                                                                                    Turkey         Hong-Kong       used these names to send them letters inviting them to
                                                                              125   France         Croatia
                            26                                                      Portugal       Saudi Arabia    become an EAFPS member. The responses were amazing:
                                                                                    Spain          U.S.A
                                      38                                            Denmark        Other           10-20% of them applied for becoming an EAFPS-member.
                                                                                                                   So we would like all national delegates to continue searching
                                                                  77

      4
for new potential EAFPS-members and continue to send us             Currently fellowships have been for three or six month peri-
their names and addresses. The figures give some                    ods. The tenure of one year falls in line with other Facial
information about our current membership structure,                 Plastic Surgery Societies linked to the International Federa-
consisting of 546 full members, 12 senior members, 84               tion of Facial Plastic Surgery Societies and enables fellows to
affiliate members (total: 652).                                     sit the American Academy of Facial Plastic and Reconstruc-
                                                                    tive Surgery exam. Sitting this exam is now a requirement of
                                                                    the fellowship.
Future tasks
We have applied for a European-copyright of our EAFPS-              All national representatives will be approached in the near
logo. This process is on its way and we expect to receive the       future to provide details of units in their countries that can of-
copyright within the next year. It will protect our Academy         fer high quality training in facial plastic surgery. The execu-
from colleagues using our high reputation for purposes not in       tive board of the EAFPS hope then to be able to draw up de-
our interest.                                                       finitive training programmes and centres for fellows. It is en-
We want to support the numerous activities of our commit-           visaged that the education committee and fellowship commit-
tees and of all our members in facial plastic surgery. We           tee will merge with Koen Ingles helping direct and formulate
want to grow further and increase the number of our mem-            a fellowship syllabus and Sandteep Paun helping develop a
bers by strengthening ...                                           certification process. Training modules may also be devel-
                                                                    oped in centres in the USA.
       • service to members
       • education                                                  The new application requirements and regulations are posted
                                                                    on the EAFPS website.
       • PR-activities, academic as well as public.
                                                                                                          Julian Rowe-Jones
Finally I like to thank the „treasurer’s secretary“ Gabi
Behncke, who has done a great and very ambitious job, and
the many colleagues from the committees, the boards and the
national delegates who have supported me and our commit-
ment for the European Academy of Facial Plastic Surgery.
                                                    Ralf Siegert
EAFPS Media Library
At the EAFPS Conference in Dublin, the following EAFPS
CDs and DVDs were demonstrated:

•      Rhinoplasty: Hump resection and micro-osteotomies
       (G. Nolst Trenité)
•      External rhinoplasty: The overprojected nose (G.
       Nolst Trenité)
•      Otoplasty: The most effective incision and suturing
       techniques (W. Heppt, R. Siegert)
•      Cadaver dissection in facial plastic surgery (K. Ingels)
•      Plastic-aesthetic reconstruction of facial defects (W.
       Heppt, C. East, H. Breuninger, W. Gubisch)

European Academy of Facial Plastic
Surgery Fellowship Committee Report
The Fellowship Committee awarded three EAFPS
fellowships in open competitive interview in March 2006.
The interviews were held at The Royal Society of Medicine
in London and the interview panel comprised Charles East,
Sandteep Paun, Nick Marks and Julian Rowe-Jones. Fifteen
candidates had applied and six were shortlisted. The three
candidates offered fellowships were Norbert Gorski from
Poland, Paul Chatrah from the UK and Dean Kissun from the
UK. Ten applicants were from the UK, two were from
Poland, one from The Netherlands, one from the Middle East
and one from Ireland. The three fellowships awarded in              Efrain Davalos Award
2005 were to Peter Andrews from the UK, Paul van de                 At the recent 9th International Sympo-
Eerden from The Netherlands and Dr Petropolous from                 sium in Las Vegas, Gilbert Nolst
Greece.                                                             Trenite was presented with the Efrain
                                                                    Davalos Award by J. Regan Thomas
We had an excellent brainstorming meeting in Stresa, Italy          The award recognizes those outside the
on the weekend of 21st April. In future, to fall in line with the   U.S. and Canada who have made a sig-
International Federation of Facial Plastic Surgery Societies,       nificant contribution to facial plastic
the EAFPS will award fellowships for one year duration.             surgery.

5
EAFPS Brainstrorming Meeting Stresa 2006                        still to be dealt with. The appeal of EAFPS has never been so
                                                                attractive as it is in the last years that were characterized by a
The idea of a brainstorming meeting (BM) came out about         spectacular raise in members from around 400 paying mem-
two years ago. The underlying thought of implementing such      bers for the year 2004 to more than 600 at the current date.
a periodical meeting was that the strong and fast develop-      The members list was made available and sent to the Na-
ment of our Academy needed at least a full day of “no holds     tional Delegates to stimulate those who have still not re-
barred” thought process involving Executive Board, National     newed. The collection of the yearly fees is now successfully
Delegates and Chairmen of the Standing Committees. The          managed by the Treasurer (see Treasurer report). The de-
following items were identified as the main goals of the        mography of members has been worked on to get a better
BM: 1. Build on our strengths; 2. Seize our opportunities; 3.   idea on who the Academy is representing and which needs
Minimizing our weaknesses; 4. Dealing with the threats; 5.      are expressed by our members. New National Delegations
Strengthening and enlarging a “leadership core” to assure a     have been installed, the last one being Macedonia. The web-
shared vision and operative continuity in the action of the     site has become a powerful tool to communicate with our
Academy. The 2006 BM took place again in the beautiful          members and to be present on the international arena. How-
frame of Stresa. The structure of the BM was illustrated:       ever, a supportive action needs to be put into practice to
Report from each committee, plans for the current year,         overcome some difficulties. Potential “strong” countries are
Deadlines, 2007 plan, Capture new ideas. I made up a suc-       feebly represented within the Academy, delays in complying
cinct retrospective analysis of the past two years including    with deadlines from some standing committees are to be
the many achievements that were reached and the weak areas      solved, the level of involvement from National Delegations
                                                                                                  is to be increased. The contri-
                                                                                                  butions of Chairmen of com-
                                                                                                  mittees are analytically reported
                                                                                                  in this Newsletter. The BM
                                                                                                  once more proved to be a fun-
                                                                                                  damental cornerstone of the
                                                                                                  internal life of Academy and
                                                                                                  has been definitively set as a
                                                                                                  periodical appointment in order
                                                                                                  to critically focus on lights and
                                                                                                  shadows, better define our ex-
                                                                                                  pectations, and identify where
                                                                                                  the next breakthroughs, ad-
                                                                                                  vances and paradigm shifts will
                                                                                                  occur.

                                                                                                         Pietro Palma

                                                                                               Certification
                                                                                               committee
                                                                                               minutes,
                                                                                               Stresa 2006
                                                                                               The International Federation of
                                                                                               Facial Plastic Surgical Societies
                                                                                               (IFFPSS) Certification process
                                                                                               has now been formalised and the
                                                                                               first few candidates are now
                                                                                               awaiting Certification.

                                                                                               All Facial Plastic Surgery Socie-
                                                                                               ties come under the umbrella of
                                                                                               the IFFPSS and the Certification
                                                                                               process is standardised for all
                                                                                               member societies. Such certifica-
                                                                                               tion requires acceptance of 100
                                                                                               operative reports of Facial Plastic
                                                                                               Surgery cases by a local peer re-
                                                                                               viewed committee and a success-
                                                                                               ful pass of an 8 hour written and
                                                                                               oral examination process. The
                                                                                               examination currently being used
                                                                                               is that administered by the Ameri-
                                                                                               can Board of Facial Plastic and
                                                                                               Reconstructive Surgery

6
    (ABFPRS). All candidates should have been in specialist
    practice for a minimum of 2 years.

There are currently two ways to apply. Officially appointed
Fellows of the European Academy of Facial Plastic Surgery
(EAFPS) who are Otolaryngology or Plastic Surgery trained
may sit for the examination first and thereafter produce the
relevant cases after their first two years in practice. All other
candidates need to forward 100 operative reports to the
EAFPS credentials committee for consideration. A list of
acceptable procedures is available through the EAFPS secre-
tariat. Following successful completion of both parts of the
process, the successful candidate will be certified by the
IFFPSS Certification committee. Whilst the member society
is able to forward a candidate for consideration, final approval
lies with this committee. Four candidates in 2005 and three
candidates in 2006 passed the examination.
                                                                               The 11th Winter
It was decided that the 350 Euro fee currently set for the ex-                 Meeting will be
tra administration required would be incorporated with the                     held in coop-
fee payable to the ABFPRS for the examination. It was sug-
gested that a total fee of 1500 Euros would be acceptable but                  eration with the
a final figure is to be agreed with Ralf Siegert. Further de-                  German Soci-
tails, including all eligibility criteria as set out by the                    ety of Aesthetic
IFFPSS, and application forms are available through Barbara
Komoniewska at admin@Entuk.org. Further details regard-                        Surgery
ing the examination are available as a report currently pub-                   (GÄCD).
lished on the EAFPS website which is to be updated by SP.

The closing date for application through the EAFPS is now
changed to 1st October every year to sit for the following
year’s examination to allow for consideration of the appli-
cations by the Credentials committee such that a final list of
candidates can be sent to the IFFPSS by January. For next                     cultural heritage have merged seamlessly over the centuries
year’s Certification process (2008 examination), the applica-                 to create an atmosphere simply unique to Dublin.
tion form and eligibility requirement’s will be placed on the                 The Meeting was coordinated by Mr. Andrew Maguire and
website for direct download. For this year, BK will remain                    Prof. Michael Walsh and by the executive board of the Euro-
the main point of contact. All materials are to be left with                  pean Academy of Facial Plastic Surgery. Mr. Maguire, na-
BK at the Royal College Office at present.                                    tional representative of the EAFPS for Ireland said that
                                                                              “Facial plastic surgery is one of the most demanding areas of
                                                  Santdeep Paun,              surgery because it deals with abnormality or disfigurement of
                                                                              the most highly, most human and most emotive area of the
EAFPS 2006 An-                                                                body. It is certainly a topic that has attracted growing interest
nual Conference                                                               in Ireland”.
Dublin, Ireland,                                                              The 2006 EAFPS
September 4-6                                                                 Conference had a
For over two hundred                                                          wide appeal to many
years, the Royal Col-                                                         disciplines sharing
lege of Surgeons in                                                           an interest in Facial
Ireland (RCSI) has                                                            Plastic Surgery in-
played a role in Irish                                                        cluding ENT/Head
surgical and medical education and although the beautiful                     and Neck, Plastic,
original building has stood unchanged on the corner of St                     Maxillofacial, Ocu-
Stephen’s Green, since the College’s inception in 1784 its                    loplastic and Der-
historic façade belies the RCSI’s progressive and innovative                  matologic Surgery.
activities. Moreover, Dublin is a place where tradition and                   On monday, Prof.
                                                                              Nolst-Trenite gave a
                                                                              comprehensive
                                                                              coverage of “Short
                                                                              Nose” and Prof.
                                                                              Palma shared his ex-
                                                                              periences with “The
                                                                              Failed Nasal Profile-
    The Organising Comittee with Dr. Lengele. From left to right: Andrew
    Maguire, Gilbert Nolst Trenite, Ralf Siegert, Benoit Lengele and Pietro   plasty”.

7
During the “Techniques for Facial Plastic Surgery” session,       Everybody enjoyed the keynote lecture “Portrait Face”, on
Kris Conrad from Canada highlighted his experiences with          plastic surgery and art given by the distinguished Irish artist
Goretex implants in Rhinoplasty. Dr. Benoit Lengele, mem-         and president of the Royal Hiberian Academy, Dr. Thomas
ber of the French team that successfully performed the            Ryan. He appraised facial features from the viewpoint of a
world’s first human face transplant, delivered a keynote lec-     portrait painter and illustrated his presentation with his paint-
ture on “Facial Transplantation”. He spoke about the ethical,     ings. The day ended with the College presentation to “Guest of
medical and psychological problems raised by the procedure        Honour” at this year’s event, Prof. Wilfred Goodman, a pio-
and defined the result as a “ Mixed image of donor and the        neer of the external approach in rhinoplasty.
recepient that moves and feels as the recepient”. In the after-
noon session, surgical rejuvenation techniques of the upper       Besides the high quality of the lectures and interactive and
third of the face including Brow Lift and Blepharoplasty. The     lively discussions, the delegates also had the opportunity to
Joseph Lecture “Facial Plastic Surgery-A Global Speciality”       enjoy Dublin’s vibrant nightlife and some extended their stay
was given by Dr. Wayne Larrabee, President of the American        in Ireland in the capital or for a more relaxed rural break , both
Academy of Facial Plastic Surgery. Dr. Larrabee discussed         of which offer a traditional and historic experience. The next
this year’s introduction of a worldwide standard for facial       biennial Congress of EAFPS will be held in Düsseldorf, Ger-
plastic surgeons that will certify surgeons who have rigor-       many from September 24th through 28th 2008. For details
ously trained and successfully completed their examinations       please visit www.eafps-due2008.eu
as experts in Facial Plastic Surgery.                                                                           Nesil Keles

The Gala Reception and
Dinner was held in Conrad
Hotel and will be remem-
bered by all participants.

The rhinoplasty session on
Tuesday concentrated on
“The Difficult Nose and
Revision Surgery” and the
speakers shared their experi-
ences with the delegates. Dr.
Wolfang Gubisch, Stuttgart,
Germany, and Dr. Kris Con-
rad, Canada, illustrated that
“An ‘easy nose’ may be
extremely difficult, if it be-
longs to a difficult patient.
Management of Facial Skin
Lesions and Repair includ-
ing Mohs’ technique were
discussed during the “Facial
Reconstruction” session. In
the afternoon Dr. Kambiz
Golchin defined “alar wid-
ening sutures” for alar ex-
pansion. Following that,
otoplasty techniques, revi-
sions, complications as well
as management of microtia
and macrotia were covered
highlighting different tech-
niques of Otoplasty. Dr.
Werner Heppt spoke on the
“Walter          Technique”,
Mr.Tony Bull on “Suture
Techniques”       and      Dr.
Hermann Raunig talked on a
less aggressive “Scoring
Technique” for otoplasty.
Dr. Ralf Siegert gave an
excellent presentation on
“Microtia Repair”. Each of
the guest speakers were also
discussed controversial is-
sues and stimulated the au-
dience to lively discussions.

8

				
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