Rod Rohrich from Texas chaired this session on which I was a panelist together with Ed Farrior, Sam Most, Steven Parlman and Vito Quatela.  We all presented one case on which our fellow panelists commented.  I presented a case of a girl with a saddle nose following trauma who’d had surgery elsewhere that had involved lowering of the bridge and stitches to the tip.  My main message was that the nose to look slim and defined needs a framwork putting back into it rather than tissue being removed as this will better support the skin and restore shape.  I used rib cartilage to rebuild the nose to give it a new structure.  We all agreed that generally revision surgery is performed to correct cases in which too much tissue has generally been removed leaving the skin of the nose with insufficient support.  The remaining cartilage under the skin also tends to buckle as it is not strong enough.  We also discussed that special psychological understanding and care is often required in revision patients who are unhappy and disappointed at the results of their first surgery and who may also be perfectionist in nature when they consider more surgery.  Another great session.  Contributing to a panel makes me reflect carefully on my ideas and makes me reassess them.  Also gives me the opportunity to discuss and learn from my colleagues too which is invigorating.