Video 2.2: Submembranous Dissection Plane with the TAŞ1 and TAŞ2 Instruments

What this video shows

Video 2.2 demonstrates every stage of the submembranous dissection plane, the plane under the perichondrium and periosteum that keeps the entire soft tissue cover intact while the cartilage and bone are reshaped. The dissection is performed with TAŞ1 and TAŞ2, the instruments invented by the author: TAŞ1 has a sharp, delicate tip designed to enter under the perichondrium, while TAŞ2 has a blunt, hard L-shaped tip that fits the border of the nasal bone, cuts the pyriform ligament and penetrates under the periosteum in one move.

The video also illustrates the Room Concept described in the book: there is no single continuous plane through the nose, and the dissection is interrupted by wall-like ligamentous structures that must be transected to move from one anatomical room to the next. The book notes that the submembranous plane produces a thick soft tissue cover, which is an advantage for thin-skinned patients, while thick-skinned patients are better served by the DUAL dissection plane.

Key points

• Complete submembranous dissection performed through a closed approach.

• TAŞ1 (subperichondrial entry) and TAŞ2 (subperiosteal entry, pyriform ligament release) shown in use.

• Illustrates the Room Concept and the ligamentous walls between dissection rooms.

For patients: dissecting under the membrane protects the blood vessels, lymphatics and skin of the nose, which is the basis of the 'atraumatic' rhinoplasty philosophy and its quick, comfortable healing.

In the book: Chapter 2 – Closed Atraumatic Rhinoplasty, section 2.2.3 Dissection Plane and 2.2.3.1 Room Concept, pp. 8–14 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Related publication record: New Instruments for Submembranous Dissection in Rhinoplasty.

Surgeon: Prof. Dr. Suleyman Tas, plastic, reconstructive and aesthetic surgeon, Istanbul. This video is part of the surgeon-training material of the book; patients considering rhinoplasty in Istanbul can use it to understand the techniques used at Prof. Dr. Suleyman Tas Clinic.