Tessier Periosteal Elevator, 18cm, Tips 6mm to 11mm

What the Tessier periosteal elevator is

The Tessier periosteal elevator is a hand instrument used to lift periosteum and soft tissue off the facial skeleton. Surgeons also call it a Tessier elevator or a craniofacial periosteal elevator. It is made by Adas Instruments in high quality medical grade stainless steel, and it is reusable and fully autoclavable.

It is 18 cm long with a curved working end in four widths from 6 mm to 11 mm, a heavier build than a nasal elevator because it strips periosteum over the orbital rim, the malar surface and the mandible.

The work an elevator does is always the same in principle. A layer of soft tissue is stuck to the cartilage or bone under it, and it has to come off in one sheet without a hole in it. Get that right and the rest of the case has a dry field and a flap that will lie back down. That is why the shape of the working end and the stiffness of the blade decide which pattern a surgeon picks up.

Key design features of the Tessier periosteal elevator

• Overall length 18 cm, about 7 in, which keeps the handle outside the wound
• Curved working end supplied in 6 mm, 7 mm, 9 mm and 11 mm widths
• Heavier shaft than a nasal elevator, because periosteum over facial bone takes more force
• Wide tips strip a broad plane in fewer passes across the malar surface and the orbital rim
• Blunt working end that raises periosteum in one sheet
• High quality medical grade stainless steel, reusable and autoclavable

The handle is flat and knurled rather than round. A flat handle tells you where the blade is facing without looking at it, and the knurling holds when a glove is wet. The shaft runs straight into the blade with no step, so there is no shoulder to catch on the rim of a nostril and nothing for protein to sit in after a case.

Tessier elevator sizes and build options

Every size below is a size we actually ship. Imperial figures are given beside the metric because United States buyers search in inches.

Nothing is listed above that we do not hold. If a build you need is not in the table, ask, because a pattern like this is often made to order for an OEM run and a change of size is a tooling change rather than a new instrument.

Uses of the Tessier periosteal elevator by specialty

The Tessier periosteal elevator appears on the same trays across these specialties because the job is the same one each time, lifting a tissue plane cleanly off what lies under it.

The specialty name and the procedure name are both worth knowing when you order, because catalogues file this pattern under whichever of the two the buyer used. An operating room manager searches by procedure and a purchasing office searches by specialty, and they are looking for the same instrument.

Tissue planes the Tessier periosteal elevator works in

An elevator handles no suture and no needle. What decides the choice of pattern is the plane it has to open and how much force that plane takes.

Force is the part nobody writes down. Perichondrium on young cartilage lifts with almost nothing, while mucoperiosteum on bone needs a firm push and a stiff blade behind it. Match the blade to the plane and the instrument does the work instead of your wrist.

How the Tessier periosteal elevator compares with other patterns

These four sit next to each other on a craniofacial tray and they are not interchangeable.

Surgeons who use this pattern usually also hold the Joseph periosteal elevator, the Howarth septum elevator and the Cottle septum elevator. The closest relative in the range is the Joseph periosteal elevator. Over the facial skeleton the Dingman zygomatic elevator lifts the bone itself while the Read periosteal elevator strips a narrower plane, and the Kleinert Kutz elevator dissector is the fine hand pattern.

If you are building a tray from scratch, the usual answer is two elevators rather than one. Something light for cartilage and something stiffer for bone covers almost every case.

Materials and finish

The instrument is made in high quality medical grade stainless steel. The steel itself is made to a German specification. The blade is flat ground and satin finished, which cuts glare under the lights in an operating room and keeps the working end readable against wet tissue. There is no coating to chip and nothing on the shaft to trap protein.

Stainless steel is chosen here for a reason that has nothing to do with appearance. An elevator is levered, and a levered instrument that is too hard will crack at the neck while one that is too soft will take a set and stay bent. The grade used sits between the two.

Tessier periosteal elevator care and sterilization

Rinse the instrument in cool water straight after use so blood does not dry on the blade. Clean it with a soft brush and a neutral pH enzymatic detergent, rinse in deionized water, then dry it completely. Steam autoclave at 134 degrees Celsius. Lay it in the tray so the blades do not rest against other instruments, because a bruised edge on an elevator is what tears a flap.

Look at the working end against the light before every case. A blunt end should be smooth with no flat spot and no nick, and a working edge should still sit flat on bone. An elevator that has been dropped on a tiled floor is the one that buttonholes a flap two cases later, and it costs nothing to check.

Ordering and wholesale

This pattern is supplied by Adas Instruments to hospitals, surgical distributors and OEM buyers, in single units and in bulk. The item code is AN-69.06 and it is printed in the size table above so a procurement search finds it. Backorder items dispatch in 10 to 12 working days. Every instrument carries a three year replacement against manufacturing defects.

For wholesale and OEM orders, instruments ship unpackaged in bulk or individually poly bagged, and laser marking with a distributor code or a hospital asset number is available on the shaft. Tell us the quantity and the marking you need and the quotation comes back with the lead time for that run rather than a stock figure.

Production is controlled under an ISO 13485 quality management system.

Frequently asked questions

What is a Tessier periosteal elevator used for?

It strips periosteum off the facial skeleton in craniofacial and maxillofacial surgery, including the orbital rim, the malar surface and the mandible. Plastic surgeons also use it for subperiosteal exposure over the nasal dorsum when a heavier blade is wanted than a nasal pattern gives.

What periosteal elevator sizes does the Tessier pattern come in?

The tip is supplied in 6 mm, 7 mm, 9 mm and 11 mm, all on an 18 cm shaft. Narrow tips follow the orbital rim and the wider tips clear the malar surface in fewer passes.

How long is the Tessier elevator?

The Tessier pattern is 18 cm overall, about 7 in, which is long enough to keep the handle outside a facial wound while the tip stays on the bone.

How is a Tessier different from a Joseph periosteal elevator?

The Tessier is the heavier of the two, with tips from 6 mm to 11 mm for broad stripping over facial bone. The Joseph runs from 2 mm to 5 mm and is the nasal and rhinoplasty pattern. Units that do both kinds of case usually hold one of each.

How do you clean and sterilize a craniofacial periosteal elevator?

Rinse it in cool water straight after use, clean with a soft brush and a neutral pH enzymatic detergent, rinse in deionized water and dry it fully, then steam autoclave at 134 degrees Celsius. Check the working edge against the light before every case.

Related products and categories

Surgeons who work with the Tessier periosteal elevator usually compare it against the Joseph periosteal elevator, the Howarth septum elevator and the Cottle septum elevator. The whole family sits in dissectors and elevators, and this pattern is also listed under rhinoplasty instruments.