It was a pleasure and honour for me to have been invited by my great friend Professor Pietro Palma to be one of the masters on his fantastic course this year.  The other masters were Abel-Jan Tasman from Switzerland, Rollin Daniel from California, Steve Perkins from Indianapolis, Roxana Cobo from Columbia, Yong Ju Jang from Seoul South Korea, Joseph Wong from Canada, Dirk Jan Menger from Amsterdam and Gilbert Nolste Trenite from Amsterdam.

I find it extremely rewarding and stimulating to be in the company of international world field leaders and to be able to discuss common difficulties, experiences and potential solutions for the future.

One area we all seem to have difficulty with is the bulbous nasal tip in which the tip cartilages are mal-positioned.  This has been called the parenthesis tip in the past.  It is my feeling that tip stitches alone can lead to loss of normal contour.  Grafting to the tip can help but this can lead to increased tip bulk at times.  I discussed with Rollin whether or not repositioning the tip cartilages might help but we both felt this could lead to disruption of the dome area.  There are many capricious aspects to aesthetic rhinoplasty!