Footplate Incision in Rhinoplasty: an Update

Aesthetic rhinoplasty procedures have increased in frequency in the Asian population. Although aesthetic concepts differ for each race, the current concept of nasal beauty shows a tendency to coincide with that of Caucasians. The ideal, beautiful nose tends to have a straight dorsum from the radix to the tip, with an adequate height. The tip should be slightly more prominent than the dorsum, and the columella must be of sufficient length to provide the necessary projection of the nasal tip above the dorsal line. The nasolabial angle should be between 90 and 110 degrees, and elliptical pear-shaped nostrils are preferred. Asians commonly desire aesthetic rhinoplasty because of a flat or low dorsum, acute nasolabial angle, poorly projected and caudally rotated tip, short columella, wide alar base, and a round or flared nostril shape [1-3]. Therefore, the surgical procedure mainly focuses on dorsal augmentation and tip projection [4]. The low nasion and dorsum can be augmented with various methods using autogenous or alloplastic materials. However, a bulbous nasal tip, wide alar base, acute nasolabial angle, and recessive pyriform fossae further compound the difficulties. The surgeon can manipulate the footplate area of the medial crus (which plays an important role in nasal tip projection, nasolabial angle, length of the columella, and nostril shape) to achieve the desired effect. In Asians, the length of the footplate segment is much longer than in Caucasians, and since Caucasians and Asians have anatomic differences in their nasal configurations, a different surgical approach would be needed for each of the different races. Jae-A Jung, Sik Namgoong, Seung-Kyu Han, Seong-Ho Jeong, Eun-Sang Dhong, Woo-Kyung Kim