Publications and lectures
2019
Lecture on the Annual Meeting of the Rhinoplasty Society of Europe, RSE, April 8, 2019, Stuttgart, Germany
Combining Rhinoplasty with Upper Lip Lift Using a Single Incision Line St.Bessler
2018
Lecture on the Annual Meeting of the Swiss Medical Society for Hypnosis (SMSH), November 2018, Balsthal, Switzerland.
“Hypnosis for Sedation and Local Anesthesia during Rhinoplasty.
Stephan Bessler
Workshop on the fall meeting of the Swiss Society of Oto-Rhino-Laryngology, Neck and Facial Surgery (SGORL), November 2018, Interlaken, Switzerland
Rhinoplasty: the more the better?
Stephan Bessler, MD, Zurich Switzerland,
Abel-Jan Tasman, MD, St.Gallen Switzerland.
2017
Lecture
Lecture on the 6TH Annual Meeting of the Rhinoplasty Society of Europe AMRSE 2017, Moskow
Combining Rhinoplasty With Upper Lip–Lift Using a Single Incision Line
St.Bessler
Scientific publication
JAMA Facial Plastic Surgery
www.jamanetwork.com/journals/jamafacialplasticsurgery
Combining Rhinoplasty With Upper Lip–Lift Using a Single Incision Line
Stephan Bessler, MD
The length of the upper lip has a great impact on the appearance of aesthetic nasal proportions, in particular, the perception of the nasal tip projection. Simons 1 estimated as esthetically ideal an upper lip length approximately equal to that of the nasal base. The combination of an open rhinoplasty with a lip-lift should be therefore considered if the upper lip length exceeds the length of the surgically planned nasal tip projection.
JAMA Facial Plast Surg. Published online October 5, 2017.doi:10.1001/jamafacial.2017.1477
2016
Lecture on the International Biennial Bergamo Open Rhinoplasty Course. March 16
Anterior spreader flap technique: a new minimally invasive method for stabilizing and widening the nasal valve
St. Bessler
2015
Scientific publication
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2015, 1-7
www.jprasurg.com
Anterior spreader flap technique: A new minimally invasive method for stabilizing and widening the nasal valve
Bessler a, H. Kim Haemmig b, B. Schuknecht c,C. Meuli-Simmen b, B. Strub b,*
a) Clinic for Facial Plastic Surgery, Beethovenstrasse 5, 8002 Zurich, Switzerland
b) Clinic for Hand-, Plastic- and Reconstructive Surgery, Cantonal Hospital, 5000 Aarau, Switzerland
c) Neuroradiology, Medizinisch Radiologisches Institut MRI, Bahnhofplatz 3, 8001 Zurich, Switzerland
Received 15 September 2014; accepted 12 August 2015
Summary
Background: The ‘anterior spreader flap’ is a new minimally invasive technique, for the treatment of nasal valve insufficiency or stenosis. The aim of this study was to present our experience with a series of patients with nasal valve dysfunction corrected by the minimally invasive spreader flap technique.
Methodology
We performed a retrospective review of our patients with nasal valve malfunction who underwent the anterior spreader flap between June 2010 and June 2013. The patients had to judge their symptoms of nasal obstruction pre- and 12 months post-operatively by the Nasal Obstruction and Septoplasty Effectiveness (NOSE) quality-of-life assessment scale. The difference between the pre- and post-operative evaluations of each group and between the groups was calculated, and it was statistically analyzed.
Results
Forty-three patients were treated. In seven patients, the anterior spreader flap was performed as a single procedure (group F), in 15 patients the anterior spreader flap was combined with a septoplasty and a turbinoplasty (group FST), in 10 patients with a turbinoplasty (group FT) and in 11 with a septoplasty (group FS). All patients reported significant postoperative improvement in nasal breathing (p < 0.05). The mean improvement (diffNOSE) of all patients was 54.2 points. The ‘FS’ group and the ‘FST’ group showed best post-operative results, but there were no significant differences between the groups (p > 0.8).
Conclusions
The anterior spreader flap is an effective and safe method for minimally invasive improvement of nasal breathing in patients with nasal valve dysfunction
Lectures at the Annual Conference
Société Suisse de chirurgie esthétique
www.plasticsurgery.ch
Lausanne, November 2015
Anterior spreader flap technique: a new minimally invasive method for stabilizing and widening the nasal valve
Strub, S. Bessler
The frontal view of the nose: lighting effects and photographic bias
Strub, S. Bessler
Lecture at the Springtime Meeting
Swiss Society of Oto-Rhino-Laryngology, Head and Neck Surgery
www.orl-hno.ch
Lugano, June 2015
Anterior spreader flap technique for stabilising and widening the nasal valve.
Bessler, B. Schuknecht, B. Stub
Scientific publication
Aesthetic Surgery Journal 2015, 1–9
www.aestheticsurgeryjournal.com
Oxford University Press
The Frontal View of the Nose: Lighting Effects and Photographic Bias
Benedikt Strub, MD; Konrad Mende, MD; Claudia Meuli-Simmen, MD; and Stephan Bessler, MD
Background
Most aesthetic rhinosurgeons rely on proper photographic documentation of the nose using several different views. The frontal view is probably the most important, but it is also the most demanding.
Objectives
In the frontal view, delicate, 3-dimensional (3D) anatomic structures require special photographic skills. Lighting is crucial for detail rendition and 3D reproduction of the nose, and for apparent photographic bias.
Methods
We compared the quality of reproduction and photographic bias with different symmetric and asymmetric lighting in common clinical practice described in the literature. The photographs were compared for anatomic reproduction, shadowing, 3-dimensionality, and apparent changes of nasal shape (bias).
Results
Symmetric lighting did not satisfy the demands of the rhinosurgeons because of marginal 3-dimensionality, reduced detail rendition, or photographic bias. Strongly asymmetric lighting altered the nasal shape adversely for bias depending on the side of illumination, but led to very good 3-dimensionality. Slightly asymmetric lighting demonstrated the best results for detail rendition and 3-dimensionality.
Conclusions
Classic symmetric quarter light is a practicable lighting technique with limitations in the rendition of detail and 3-dimensionality. Slightly asymmetric lighting offered a perfect compromise, with substantially improved detail rendition and 3-dimensionality. Strongly asymmetric lighting may lead to photographic bias depending on the side of illumination. Frontal documentation of the nose with asymmetric lighting should, therefore, always be performed in duplicate, with asymmetric lighting from the right side and from the left side, to prevent misleading interpretations
2014
Scientific publication
Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) 2014, Vol.3 No.4
http://www.scirp.org/journal/IJOHNS/
The Anterior Spreader Flap: A Minimally Invasive Alternative to the Auto Spreader Flap in the Treatment of Patients with Nasal Valve Dysfunction
Stephan Bessler, Konrad Mende, Leonid Goubergrits, Jan Osman, Benedikt Strub
We present a new method of treatment for nasal valve dysfunction caused by insufficiency or stenosis in a patient who refused open septum revision despite a significant degree of septum deviation. The Anterior Spreader Flap (ASF) technique was suggested as an alternative to open nasal septum revision and was performed under local anesthesia. Computational fluid dynamics (CFD) tests were performed pre- and post-operatively and our patient was asked to complete a self-assessment using a Visual Analog Scale (VAS) for nasal breathing (0 = free nasal breathing, 10 = complete nasal blockage) before and 12 months after surgery. The ASF is a minimally invasive endonasal procedure in which the caudal edge of the upper lateral cartilage is dissected from the septum, and folded inwards and fixed. The ASF allows for less airflow resistance and more free space. CFD techniques revealed a reduction in local pressure based on extended space. In addition, VAS scores improved from 9 to 2 points (right side) and from 8 to 2 points (left side). On the basis of these findings, the ASF technique can be considered a safe, minimally invasive spreader flap technique. It can easily be combined with other nasal surgical techniques, as it is necessary in most cases. In selected cases, the ASF may be performed as a single procedure in patients with nasal valve dysfunction caused by septum deviation as an alternative to open septum revision.
2013
Lecture at the Springtime Meeting
Swiss Society of Oto-Rhino-Laryngology, Head and Neck Surgery
www.orl-hno.ch
Zermatt, June 2013
Photodocumentation in rhinoplasty surgery
Strub, S. Bessler
The photographic documentation is an essential part of surgical planning. We present our technique of photographic documentation and we are searching for the best lightening solution for the difficult frontal view of the nose.
Material und methods
With the aid of a patient we tested different light situations with different types of cameras. We compare the results especially with regard to the frontal view of the nose.
Results
The correct exposure, the right depth of focus for the key areas of the nose, and the right camera angle are the decisive factors in a good image series. The most important views are frontal, three-quarters and profile views. In special cases, close-up images may also be necessary. Contrary to other views, the frontal view of the nose needs an asymmetric lightening situation for better representation of fine nasal structures.
Conclusion
Fixed focal length lenses with a focal length of about 105 mm are especially suited to this type of work. Six standard images are recommended for the proper documentation of nasal surgery. The frontal view needs special photographic considerations.
Book chapter
Thieme eOtolaryngology, 2013
Sclafani, Rhinoplasty: The Experts’ Reference
Chapter 23: Evaluation of the Intranasal Flow Field through Computational Fluid Dynamics
Thomas Hildebrandt, Leonid Goubergrits, Werner J. Heppt, Stephan Bessler, and Stefan Zachow
https://www.thieme.de/shop/HNO-Heilkunde/Sclafani-Rhinoplasty-9781604068672/p/000000000283100101
Scientific publication
Facial Plastic Surgery, 29, 93-98
http://dx.doi.org/10.1055/s-0033-1341591
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Evaluation of the Intranasal Flow Field through Computational Fluid Dynamics
Thomas Hildebrandt 1, Leonid Goubergrits 2, Werner Johannes Heppt 3, Stephan Bessler 4, Stefan Zachow 5
- Private practice of otorhinolaryngology in association with the Limmatklinik, Zurich, Switzerland
- Biofluid Mechanics Lab, Institute of Laboratory Medicine, Charité, Berlin, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Staedtisches Klinikum Karlsruhe, Karlsruhe, Germany
- Private practice of otorhinolaryngology, Zurich, Switzerland
- Department of Scientific Visualization and Data Analysis, Zuse Institute, Berlin, Germany
A reliable and comprehensive assessment of nasal breathing is problematic and still a common issue in rhinosurgery. Impairments of nasal breathing need an objective approach. In this regard, currently rhinomanometry is the only standard diagnostic tool available but has various limitations. However, in the last decade, computational fluid dynamics (CFD) has become a promising method in facing the challenge of qualifying nasal breathing. This article presents use of CFD with a symptom-free subject and a symptomatic patient. Thereby, certain flow field features and changes before and after surgery were investigated. Moreover, the study outlines suggestions for concrete rhinologic CFD applications.
Articles
Magazine of Limmatklinik Zurich, 2013
Magazin Limmatklinik Zürich - 2012/2013
2012
Scientific publication
European Journal of Plastic Surgery
Photodocumentation in rhinoplasty surgery
Benedikt Strub, Claudia Meuli-Simmen, Stephan Bessler
ISSN 0930-343X
Eur J Plast Surg, DOI 10.1007/s00238-012-0802-3
Springer-Verlag
http://www.scirp.org/journal/IJOHNS/
2011
Articles
Special supplements in the Tagesanzeiger
Zurich, December 2011
Sonderbeilage im Tagesanzeiger Zürich - December 2012
2010
Articles
Article in the Helsana magazine "Senso"
Zurich, December 2010
Artikel im Maganzin "Senso" der Helsana