Video 2.6: Redraping the Soft Tissue Envelope by Redistribution Instead of Skin Excision

What this video shows

Video 2.6 shows the redraping stage of the closed atraumatic technique. Because the submembranous plane keeps the perichondrium–periosteum layer attached to the skin, the soft tissue cover cannot shrink or stretch on its own; the excess must therefore be redistributed and re-fixed to the new skeleton. The book states that if redraping can be achieved by redistribution without excision, this should always be prioritised.

For very thick skin, the author adds perichondrio-SMASectomy (Chapter 4) as a further step. The video is a practical demonstration of the principle that redraping makes the result more predictable during the recovery period, especially in patients with reduced skin elasticity.

Key points

• Excess soft tissue is redistributed, not excised.

• The perichondrium–periosteum layer stays with the skin, so redraping is mandatory in the submembranous plane.

• Thick skin may additionally require perichondrio-SMASectomy.

In the book: Chapter 2 – Closed Atraumatic Rhinoplasty, section 2.2.8 Redraping and Closure, p. 16 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

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.