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The Future of Rhinoplasty and the Dallas Rhinoplasty Symposium

Dini, Gal M. Ph.D.; Albuquerque, Luciana G.; Ferreira, Lydia M. Ph.D.

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Plastic and Reconstructive Surgery: February 2009 - Volume 123 - Issue 2 - p 64e-65e
doi: 10.1097/PRS.0b013e318195954b
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The Dallas Rhinoplasty Symposium is recognized as a teaching model. For plastic surgeons and otolaryngologists, it represents the premier source of innovative changes and technical advances in rhinoplasty. It is considered the most successful “hands-on” educational symposium in the world. The symposium was the brainchild of Jack P. Gunter and grew out of his observation that plastic surgery residents lacked experience in exposure to basic anatomical and surgical concepts that constitute keys to successful rhinoplasty.1–5 I had always loved rhinoplasty and, after observing Dr. Gunter’s operating procedure, I realized that this type of surgery gave me joy and satisfaction. Nevertheless, I questioned myself: Will I be able to produce the perfect nose this time? This “easy” nose, will it be a simple procedure or will I sweat to make it?

Any extra millimeter of tissue taken off, any loose suture that cuts into cartilage, can turn my pleasure into pain. Differing from breast augmentation, where I can attempt a large sample of sizes, nose sizes have to be calculated in the mind, like the next move in a chess game. Any precipitous move may put you in check.

I have traveled from Brazil to attend these meetings for 6 consecutive years, and when my friends ask me why, I reply that one time, during lunch with Dr. Guyuron, I heard him state, “It’s amazing that every year I come here, I learn something new!” Well, who am I to miss a meeting after such a statement? Missing a meeting is like losing knowledge. I have been in rhinoplasty meetings all over the globe, but this is the only well-established school of rhinoplasty. I often saw a mixture of techniques and controversial ideas causing the audience to come out of meetings more confused than when coming in, and no consensus could be established.

However, Dallas Symposia are founders of modern rhinoplasty concepts. My suggestion is, why don’t we start a volunteer group in this meeting similar to the Operation Smile project, with younger members who have the time and the will to travel all over the world bringing Dallas concepts to annual meetings taking place also outside of the United States? I have many plastic surgeon friends who would love to attend such meetings but cannot afford the travel expenses involved; just to exemplify, a worker’s minimum salary in Russia is U.S.$20, in China approximately U.S.$80, and in Brazil it is rather similar. We must act globally in our specialty. Although plastic surgeons have been stigmatized as being rich, the earnings of an American surgeon and those of a surgeon from a Third World country differ widely. Digital access to knowledge should be provided to everyone. As a start, could not a philanthropic enterprise give financial support for the publication of an online, free version of a Dallas Symposium book or to a plastic surgery journal? Money is said to be everything, but how much could we not be able to share for this purpose? In medicine, truth is always stated in the present tense: what was taken as a law yesterday may become a crime in the next edition, because learning is a continuous process. There is no single, unique truth.

Every patient needs a personal approach. I believe that the Dallas concept is not found in just one more meeting. It is the beginning of a new philosophy in rhinoplasty, and to deny its principles is swimming against the tide. As a surgeon, one can never know enough and has to spend the rest of one’s life learning. Do not forget that the harder the work, the happier its results will make you.

Gal M. Dini, Ph.D.

Luciana G. Albuquerque

Lydia M. Ferreira, Ph.D.

Universidade Federal de São Paulo

Escola Paulista de Medicina

São Paulo, Brazil


1. Rohrich RJ, Adams WP, Gunter JP. Dallas Rhinoplasty: Nasal Surgery by the Master. St. Louis: Quality Medical Publishing; 2007.
2. Rohrich RJ, Gunter JP, Deuber MA, Adams WP Jr. The deviated nose: Optimizing results using a simplified classification and algorithmic approach. Plast Reconstr Surg. 2002;110:1509–1523.
3. Rohrich DR, Muzaffar AR. In search of the ideal nose. Plast Reconstr Surg. 2000;105:2568–2569.
4. Dini GM, Ferreira LM. Rhinoplasty and PubMed. Plast Reconstr Surg. 2006;118:289.
5. Dini GM, Ferreira LM. Nose elongation. Plast Reconstr Surg. 2006;118:289–290.

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