What the joseph skin hook is
The joseph skin hook is a fine retractor used to hold skin edges and superficial flaps back during rhinoplasty, facial plastic and dermatologic surgery. It is named after Jacques Joseph, whose work shaped modern nasal surgery, and it is still the hook most surgeons reach for on a nose.
The pattern is made as a single prong and as a double prong, and the double prong is offered in five spreads from 2 mm to 12 mm. That range is the point of the instrument. A columellar margin a few millimeters wide and a facial flap several centimeters long are both skin, but they are not the same job, and the spread is what matches the hook to the wound.
Like every hook it holds from one side only. It does not grip, it does not cut, and it stays in a hand for as long as the exposure is wanted.
Key design features of the joseph skin hook
Four features, and all of them are about working small without marking the tissue.
- Single or double prong. One anchor point where the least disturbance is wanted, two where the edge is long enough to rotate.
- Five prong spreads. 2 mm, 5 mm, 7 mm, 10 mm and 12 mm, so the lift is matched to the wound rather than the other way round.
- Fine working end. Built for nasal and facial fields, where a general plastics hook is more instrument than the space allows.
- Round handle. Turns in the fingers, which matters on a nose where the angle of pull changes constantly.
Joseph skin hook sizes and prong spreads
Six options ship from this page. The chart is the ordering answer, and the option is chosen at the point of order.
| Option | Prongs | Spread | What it suits | Item code |
|---|---|---|---|---|
| Joseph single skin hook | One | Single point | A fine margin, and the least tissue disturbed | AP-06.02 |
| Joseph double skin hook | Two | 2 mm | The narrowest wound, and columellar work | AP-06.02 |
| Joseph double skin hook | Two | 5 mm | The everyday rhinoplasty choice | AP-06.02 |
| Joseph double skin hook | Two | 7 mm | A broader facial flap | AP-06.02 |
| Joseph double skin hook | Two | 10 mm | A longer edge that needs spreading | AP-06.02 |
| Joseph double skin hook | Two | 12 mm | The widest lift in the pattern | AP-06.02 |
Our own record carries the prong options and not an overall length, so no length is stated here. If a figure is needed for a set list, ask and it will be measured. A number the workshop cannot stand behind does not belong on a product page.
Joseph skin hook uses by specialty
The table answers what the joseph skin hook surgical instrument is used for, specialty by specialty.
| Specialty | What the joseph skin hook is used for |
|---|---|
| Rhinoplasty | Holding the nasal skin envelope back during an open approach, which is the work this pattern is named for |
| ENT and rhinology | Retracting a mucosal margin and holding an intranasal edge |
| Facial plastic surgery | Lifting a facial skin flap on a chosen prong spread |
| Oculoplastic surgery | Holding eyelid skin, usually on the 2 mm double prong |
| Dermatologic surgery | Holding a margin during Mohs work, a tumor excision or a closure |
| Plastic and reconstructive surgery | General flap handling where the tissue is being kept |
| Breast and body contouring | Holding a dermal edge during a long closure without crushing it |
What the prong holds, and what it does not
A fine hook has real limits and they are worth stating rather than leaving to be discovered.
| Structure | How the prong takes it |
|---|---|
| Nasal skin | The pattern this hook exists for. Thin, mobile, and unforgiving of a crush mark |
| Columellar skin | Taken on the 2 mm double prong, because the margin is only millimeters wide |
| Facial skin flaps | Carried on a wider spread so the flap does not fold across the hook |
| Eyelid skin | Held on the 2 mm double prong, never on a single sharp point |
| Fine dermal margins | Held for closure, one point or two depending on the length of the edge |
| Mucosal margins | Held gently. Mucosa tears more readily than skin, so the bite is shallow |
| Cartilage and bone | NOT this instrument. A skin hook holds skin, and it will skid off anything firmer |
How the joseph skin hook compares with other patterns
Four of the rows below are our own hooks and the rest are named so the comparison is complete.
| Pattern | How it differs | When you reach for it instead |
|---|---|---|
| Kleinert Kutz skin hook | One fine prong on a narrow shaft in 3 mm, 5 mm and 7 mm | Hand and finger surgery, where the opening is the limiting factor |
| McCoy micro dermal single hook | A single prong at a smaller working scale again | Micro flaps and the thinnest dermal edges |
| Gillies skin hook | A general purpose single prong on a round handle, in 12 cm and 18 cm | A thicker flap, a deeper field, or a general plastics case |
| Guthrie skin hook | A double prong offered with a blunt end as well as a sharp one | Fragile and atrophic skin that should not be pierced |
| Converse skin hook | A different fine facial pattern we do not stock | Named here only so the comparison is complete |
| Fine tissue forceps | Grips between two blades along a line | Tissue being excised, where the mark does not matter |
Joseph skin hook materials and finish
Made from high quality medical grade stainless steel, satin finished so the operating light does not reflect off the shank into the eye. The steel itself is made to a German specification. The prongs are hardened at the tips, and on the double prong versions the pair is set so both points engage together rather than one leading.
Care and sterilization of a fine skin hook
Clean with a soft brush under running water, working between the prongs on the double versions where tissue collects, then rinse in deionized water and dry fully before autoclaving. Store so nothing rests on the working end. On a 2 mm spread the prongs are small enough that a knock will move them out of line, and once they no longer engage together the hook tears instead of lifting. Check the points before the instrument goes back into the set.
Ordering from surgical skin hook suppliers
Adas Instruments makes this pattern to order in single prong and in all five double prong spreads. Buyers comparing surgical skin hook suppliers should know that we manufacture rather than resell, so a set can be ordered in one spread or in a graded run of them. We supply hospitals, surgical centers and distributors across the United States, Latin America, Europe and Asia, bulk and wholesale pricing is available, and instruments held on backorder ship in 10 to 12 working days. Every instrument carries a three year replacement warranty against manufacturing defects. Certifications: CE. Production is controlled under an ISO 13485 quality management system.
Frequently asked questions
What is a joseph skin hook used for?
Holding skin edges and superficial flaps out of the field, most often in rhinoplasty and facial plastic surgery. It is the standard hook for the nasal skin envelope during an open approach, and it is used the same way on eyelid skin, on facial flaps and on dermal margins during Mohs and excisional work.
What is the purpose of a skin hook in surgery?
To retract tissue without crushing it. A hook takes the tissue on one or two points and holds it by the bend rather than by pressure, so skin that is going back into the closure is not marked. That is the whole reason a hook is chosen over a forceps on tissue the patient is keeping.
How do Gillies skin hooks differ from Joseph skin hooks?
Scale and range. The Gillies is a general purpose single prong hook in 12 cm and 18 cm, with a 2.5 mm or 5 mm prong. The Joseph is finer and is made as a single prong or as a double prong in five spreads from 2 mm to 12 mm, which is why it is the pattern for nasal and columellar work. On a thick flap take the Gillies; on a nose take the Joseph.
What is the difference between a joseph single skin hook and a double?
The number of points, and therefore how the tissue behaves. A joseph single skin hook disturbs the least tissue and is right on a short margin. A double prong spreads the pull across two points, which stops a longer edge rotating on the hook, and it is the safer choice on any flap with length to it.
Which prong spread should I order?
Match the spread to the wound. 2 mm for columellar and eyelid work, 5 mm for everyday rhinoplasty, 7 mm for a broader facial flap, and 10 mm or 12 mm where a long edge has to be lifted evenly. Surgeons who work across all of it usually keep a 2 mm, a 5 mm and a 10 mm in the set rather than one of each.
Related products and categories
Buyers who order the joseph skin hook usually order alongside it the kleinert kutz skin hook, the mccoy micro dermal single hook and the gillies skin hook. The whole family sits in hooks and retractors, and this pattern is also listed under rhinoplasty instruments.






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