Advantages of Adding a Footplate Incision in Asian Rhinoplasty

Abstract

The dimension, shape, and projection of the nasal tip are significantly determined by the position of the footplates of the medial crura. The length of the footplate segment in Asians is much longer than that in Caucasians. A surgeon may be able to use a longer footplate segment when operating on an Asian to recreate the lower vault of the nose more effectively. The purpose of this study is to introduce the advantages of addition of a footplate incision to obtain greater satisfaction in esthetic rhinoplasty for Asians. This incision is extended along the caudal border of the footplate of the medial crura onto the floor of the nasal vestibule bilaterally, in endonasal or open approach rhinoplasty. By approximating the lateral curves of the medial crural footplates, the width and the length of the columella could be narrowed and lengthened. The columella can also be advanced caudally and thus elongate the shape of the nostrils. In addition, a cartilage graft or an implant insertion for alar base augmentation could be performed through this footplate incision, eliminating the need for an additional incision. Another advantage is that, during the correction of caudal septal deviation, displaced septal cartilage can be repositioned by suturing to the periosteum or soft tissue around the anterior nasal spine without drilling into it through an intraoral incision. One hundred ten consecutive patients who underwent esthetic rhinoplasty using our footplate incision technique between August of 1999 and May of 2002 were included in this study. A total of 66 patients had an adequate follow-up time of over 6 months. Patient satisfaction and postoperative complications were recorded. The majority of the patients (57/66 cases) were satisfied with the results of the procedure. The authors believe that the addition of the footplate incision in esthetic rhinoplasty is safe and reliable for effecting better results for Asians.

Aesthetic surgery in Asians

“…The foot process of the L-implant usually rests between the medial crurae. Nasal tip projection can be further augmented with nasal tip interdomal sutures [46 ], lengthening the columella [47] or adding a footplate incision to gain extra tip mobility [48]. Variations of the 'L'-shaped implant have been described and softening of the silicone nasofrontal end has been reported [49 ].…”

Geniş kolumella ve vestibulum nasi stenozu olan hastada alar medial krus kaydırma flebi ile rekonstrüksiyon

“…3 Kolumella taban›n›n geniflli¤i primer olarak medial krus footplate'lerinin birbirlerinden ne kadar uzaklaflt›klar›na ba¤l›d›r. Medial kruslar›n anatomik yap›-s› d›fl›nda kaudal septumun kal›nl›¤› ve bu alandaki yumuflak dokular›n miktar› da geniflli¤i belirler.…”

“…aç›k teknik rinoplasti ile opere ettikleri hastalarda ek olarak footplate insizyonu da yaparak kolumellan›n boyut, biçim ve uzunlu¤unda de¤ifliklikler yapm›fllard›r. 3 Ancak vakalar›n tamam›nda bu prosedürü aç›k teknik rinoplasti operasyonu esnas›nda uygulam›fllar, rekonstrüksiyon amaçl› olarak lokal anesteziyle ve flep tarz›nda kald›rmam›fllard›r. Ayr›ca tabanda W insizyonu, baz› alanlarda doku eksizyonu ve nareslere yönelik de¤i-fliklik yapmam›fllard›r.…”

Aesthetic and functional corrections in case of foot plate deformities in rhinoplasty

“…Footplates, located at the posterior end of the medial crura, significantly impact the aesthetic outcome of the nasal tip [3,4]. The dimensions, shape, and projection of the nasal tip are significantly determined by the position of the footplates [5]. Their configuration, alignment, and proportion are essential considerations in rhinoplasty, and deviations can lead to noticeable changes in appearance [6].…”