닫기

Ex) Article Title, Author, Keywords

Case Report

Split Viewer

J Cosmet Med 2023; 7(2): 81-83

Published online December 31, 2023

https://doi.org/10.25056/JCM.2023.7.2.81

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

Hyejeen Kim , MD, Young Jae Lee , MD, Ji Yun Choi , MD, PhD

Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea

Correspondence to :
Ji Yun Choi
E-mail: happyent@naver.com

Received: November 8, 2023; Revised: December 5, 2023; Accepted: December 5, 2023

© Korean Society of Korean Cosmetic Surgery & Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

The nasal tip is the central component of facial aesthetics and is important in the overall appearance of the nose. Footplates, located at the posterior end of the medial crura, significantly impact the aesthetic outcome of the nasal columella. In our case, a 60-year-old woman with an abnormal nasal shape due to footplate deformity underwent successful correction through rhinoplasty. Successful correction using rhinoplasty highlights its potential benefits in addressing nasal columellar irregularities and their functional aspects.

Keywords: foot plate deformities, foot plate plasty, rhinoplasty

The nasal tip is the central component of facial aesthetics and is important in the overall appearance of the nose [1]. Structural integrity and balance are essential for form and function [2]. The intricate interplay between various anatomical structures, such as the medial and lateral crura, footplates, and columella, contributes to the aesthetics and functionality of the nasal tip. Understanding these anatomical relationships is crucial for successful rhinoplasty. The support system for the nasal tip is characterized by the lateral and medial crura, which form two arches. The medial crura acts as a foundational pillar resting on the footplates. 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]. Footplate irregularities may manifest as differences in length, conformation, or spacing, ultimately causing nasal skin protrusion [3,7]. Various factors, including genetics, trauma, growth abnormalities, previous surgeries, and infections, can contribute to the development of columellar deformities. Columellar deformities may cause significant aesthetic and functional problems [8,9]. Here, we report a case of footplate deformities corrected using an external approach.

A 60-year-old woman visited the outpatient clinic complaining of aesthetic and functional problems due to the abnormal shape of the nasal cavity (Fig. 1). She had experienced discomfort while breathing through the nose for 5 years.

Fig. 1.Preoperative image showing footplate deformity.

On visual examination, the patient was diagnosed with footplate deformity. For evaluation of allergic disease, an immunoglobulin E (IgE)-MAST test was performed, and there was no positive reaction to allergens, and total IgE was 18.5 IU/ml as normal range. There was no evidence of nasal discomfort with breathing, excluding footplate deformities. Therefore, rhinoplasty was planned. Surgery was performed under local anesthetic infiltration (1% lidocaine mixed with 1:200,000 epinephrine). An inverted V-shaped incision was made on the columella to elevate the flap. The medial crura was released from the skin attachment on both sides. The average height of the footplate was 5–6 mm and the distance between both sides footplate was 7.5–15 mm. In this case, the distance between both sides of the footplate was >15 mm. The deformed lower parts of the medial crural footplate were resected. After the resection of the medial crura, the septum was sutured using the through-and-through suture technique. Skin closure was performed (Fig. 2).

Fig. 2.(A) An inverted V-incision on the columella to elevate the flap and deformities on the lower parts of the medial crura footplate are found. (B) A line was drawn on the medial crura of the footplate. (C) The resection of the deformed lower parts of the medial crura footplate. (D) After skin closure with ethylone 5-0, the columella narrowed.

Postoperatively, she felt more comfortable breathing with the nose and was satisfied with the nose shape (Fig. 3).

Fig. 3.Postoperative image at 9 months.

This case highlights the importance of footplate deformities in rhinoplasty for aesthetic and functional outcomes [3-5]. The structural integrity of the nasal tip is crucial for facial aesthetics and function [1]; especially, columellar deformities, which may cause significant aesthetic and functional problems [8,9].

A 60-year-old woman with an abnormal nasal shape due to footplate deformity underwent successful correction through rhinoplasty. Intricate anatomical relationships should be considered during rhinoplasty. Footplate irregularities can be caused by genetics, trauma, growth issues, previous surgeries, or infections, leading to skin protrusion [3,5]. The treatment involved an inverted V incision on the columella, release of the medial crura, and resection of the deformed parts of the footplate.

Precise surgical techniques contribute to desired nasal aesthetics. Patient-specific plans, such as rhinoplasty under local anesthesia, can minimize patient discomfort.

A larger group of studies with long-term follow-up are needed to define the effectiveness and benefits of rhinoplasty. Through further studies, postoperative care, complications, and patient satisfaction can be understood.

Overall, this case emphasizes the interplay between nasal tip structure, facial aesthetics, and function. Successful correction using rhinoplasty highlights its potential benefits in addressing nasal columellar irregularities and their functional aspects. Understanding anatomy and innovative techniques can lead to better patient outcomes and satisfaction.

The authors have nothing to disclose.

  1. Krane NA, Markey JD, Moneta LB, Kim MM. Aesthetics of the nasal dorsum: proportions, light, and shadow. Facial Plast Surg 2017;33:120-4.
    Pubmed CrossRef
  2. Dresner HS, Hilger PA. An overview of nasal dorsal augmentation. Semin Plast Surg 2008;22:65-73.
    Pubmed KoreaMed CrossRef
  3. Guyuron B. Footplates of the medial crura. Plast Reconstr Surg 1998;101:1359-63.
    Pubmed CrossRef
  4. Uppal R, Yousif AH, Maheshwari K. Outcome-based comparative study to examine the correction of columella deformitiesfollowing rhinoplasty. Plast Reconstr Surg Glob Open 2020;8:e3001.
    Pubmed KoreaMed CrossRef
  5. Han SK, Ko HW, Kim WK. Advantages of adding a footplate incision in Asian rhinoplasty. Ann Plast Surg 2004;53:65-9.
    Pubmed CrossRef
  6. Jung JA, Namgoong S, Han SK, Jeong SH, Dhong ES, Kim WK. Footplate incision in rhinoplasty: an update. Arch Aesthetic Plast Surg 2015;21:54-8.
    CrossRef
  7. Moina DG, Moina GM. Sutures or resection of the protruding end of medial crura. In: Serdev N, editor. Miniinvasive techniques in rhinoplasty. London: IntechOpen; 2016.
    CrossRef
  8. Bilkay U, Tokat C, Ozek C, Erdem O, Cagdas A. Reconstruction of congenital absent columella. J Craniofac Surg 2004;15:60-3.
    Pubmed CrossRef
  9. Ozek C, Gundogan H, Bilkay U, Alper M, Cagdas A. Nasal columella reconstruction with a composite free flap from the root of auricular helix. Microsurgery 2002;22:53-6.
    Pubmed CrossRef

Article

Case Report

J Cosmet Med 2023; 7(2): 81-83

Published online December 31, 2023 https://doi.org/10.25056/JCM.2023.7.2.81

Copyright © Korean Society of Korean Cosmetic Surgery & Medicine.

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

Hyejeen Kim , MD, Young Jae Lee , MD, Ji Yun Choi , MD, PhD

Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea

Correspondence to:Ji Yun Choi
E-mail: happyent@naver.com

Received: November 8, 2023; Revised: December 5, 2023; Accepted: December 5, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The nasal tip is the central component of facial aesthetics and is important in the overall appearance of the nose. Footplates, located at the posterior end of the medial crura, significantly impact the aesthetic outcome of the nasal columella. In our case, a 60-year-old woman with an abnormal nasal shape due to footplate deformity underwent successful correction through rhinoplasty. Successful correction using rhinoplasty highlights its potential benefits in addressing nasal columellar irregularities and their functional aspects.

Keywords: foot plate deformities, foot plate plasty, rhinoplasty

Introduction

The nasal tip is the central component of facial aesthetics and is important in the overall appearance of the nose [1]. Structural integrity and balance are essential for form and function [2]. The intricate interplay between various anatomical structures, such as the medial and lateral crura, footplates, and columella, contributes to the aesthetics and functionality of the nasal tip. Understanding these anatomical relationships is crucial for successful rhinoplasty. The support system for the nasal tip is characterized by the lateral and medial crura, which form two arches. The medial crura acts as a foundational pillar resting on the footplates. 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]. Footplate irregularities may manifest as differences in length, conformation, or spacing, ultimately causing nasal skin protrusion [3,7]. Various factors, including genetics, trauma, growth abnormalities, previous surgeries, and infections, can contribute to the development of columellar deformities. Columellar deformities may cause significant aesthetic and functional problems [8,9]. Here, we report a case of footplate deformities corrected using an external approach.

Case report

A 60-year-old woman visited the outpatient clinic complaining of aesthetic and functional problems due to the abnormal shape of the nasal cavity (Fig. 1). She had experienced discomfort while breathing through the nose for 5 years.

Figure 1. Preoperative image showing footplate deformity.

On visual examination, the patient was diagnosed with footplate deformity. For evaluation of allergic disease, an immunoglobulin E (IgE)-MAST test was performed, and there was no positive reaction to allergens, and total IgE was 18.5 IU/ml as normal range. There was no evidence of nasal discomfort with breathing, excluding footplate deformities. Therefore, rhinoplasty was planned. Surgery was performed under local anesthetic infiltration (1% lidocaine mixed with 1:200,000 epinephrine). An inverted V-shaped incision was made on the columella to elevate the flap. The medial crura was released from the skin attachment on both sides. The average height of the footplate was 5–6 mm and the distance between both sides footplate was 7.5–15 mm. In this case, the distance between both sides of the footplate was >15 mm. The deformed lower parts of the medial crural footplate were resected. After the resection of the medial crura, the septum was sutured using the through-and-through suture technique. Skin closure was performed (Fig. 2).

Figure 2. (A) An inverted V-incision on the columella to elevate the flap and deformities on the lower parts of the medial crura footplate are found. (B) A line was drawn on the medial crura of the footplate. (C) The resection of the deformed lower parts of the medial crura footplate. (D) After skin closure with ethylone 5-0, the columella narrowed.

Postoperatively, she felt more comfortable breathing with the nose and was satisfied with the nose shape (Fig. 3).

Figure 3. Postoperative image at 9 months.

Discussion

This case highlights the importance of footplate deformities in rhinoplasty for aesthetic and functional outcomes [3-5]. The structural integrity of the nasal tip is crucial for facial aesthetics and function [1]; especially, columellar deformities, which may cause significant aesthetic and functional problems [8,9].

A 60-year-old woman with an abnormal nasal shape due to footplate deformity underwent successful correction through rhinoplasty. Intricate anatomical relationships should be considered during rhinoplasty. Footplate irregularities can be caused by genetics, trauma, growth issues, previous surgeries, or infections, leading to skin protrusion [3,5]. The treatment involved an inverted V incision on the columella, release of the medial crura, and resection of the deformed parts of the footplate.

Precise surgical techniques contribute to desired nasal aesthetics. Patient-specific plans, such as rhinoplasty under local anesthesia, can minimize patient discomfort.

A larger group of studies with long-term follow-up are needed to define the effectiveness and benefits of rhinoplasty. Through further studies, postoperative care, complications, and patient satisfaction can be understood.

Overall, this case emphasizes the interplay between nasal tip structure, facial aesthetics, and function. Successful correction using rhinoplasty highlights its potential benefits in addressing nasal columellar irregularities and their functional aspects. Understanding anatomy and innovative techniques can lead to better patient outcomes and satisfaction.

Conflicts of interest

The authors have nothing to disclose.

Fig 1.

Figure 1.Preoperative image showing footplate deformity.
Journal of Cosmetic Medicine 2023; 7: 81-83https://doi.org/10.25056/JCM.2023.7.2.81

Fig 2.

Figure 2.(A) An inverted V-incision on the columella to elevate the flap and deformities on the lower parts of the medial crura footplate are found. (B) A line was drawn on the medial crura of the footplate. (C) The resection of the deformed lower parts of the medial crura footplate. (D) After skin closure with ethylone 5-0, the columella narrowed.
Journal of Cosmetic Medicine 2023; 7: 81-83https://doi.org/10.25056/JCM.2023.7.2.81

Fig 3.

Figure 3.Postoperative image at 9 months.
Journal of Cosmetic Medicine 2023; 7: 81-83https://doi.org/10.25056/JCM.2023.7.2.81

References

  1. Krane NA, Markey JD, Moneta LB, Kim MM. Aesthetics of the nasal dorsum: proportions, light, and shadow. Facial Plast Surg 2017;33:120-4.
    Pubmed CrossRef
  2. Dresner HS, Hilger PA. An overview of nasal dorsal augmentation. Semin Plast Surg 2008;22:65-73.
    Pubmed KoreaMed CrossRef
  3. Guyuron B. Footplates of the medial crura. Plast Reconstr Surg 1998;101:1359-63.
    Pubmed CrossRef
  4. Uppal R, Yousif AH, Maheshwari K. Outcome-based comparative study to examine the correction of columella deformitiesfollowing rhinoplasty. Plast Reconstr Surg Glob Open 2020;8:e3001.
    Pubmed KoreaMed CrossRef
  5. Han SK, Ko HW, Kim WK. Advantages of adding a footplate incision in Asian rhinoplasty. Ann Plast Surg 2004;53:65-9.
    Pubmed CrossRef
  6. Jung JA, Namgoong S, Han SK, Jeong SH, Dhong ES, Kim WK. Footplate incision in rhinoplasty: an update. Arch Aesthetic Plast Surg 2015;21:54-8.
    CrossRef
  7. Moina DG, Moina GM. Sutures or resection of the protruding end of medial crura. In: Serdev N, editor. Miniinvasive techniques in rhinoplasty. London: IntechOpen; 2016.
    CrossRef
  8. Bilkay U, Tokat C, Ozek C, Erdem O, Cagdas A. Reconstruction of congenital absent columella. J Craniofac Surg 2004;15:60-3.
    Pubmed CrossRef
  9. Ozek C, Gundogan H, Bilkay U, Alper M, Cagdas A. Nasal columella reconstruction with a composite free flap from the root of auricular helix. Microsurgery 2002;22:53-6.
    Pubmed CrossRef

Stats or Metrics

Share this article on :

  • line

Related articles in JCM

Most KeyWord ?

What is Most Keyword?

  • It is most registrated keyword in articles at this journal during for 2 years.

Journal of Cosmetic Medicine

eISSN 2586-0585
pISSN 2508-8831
qr-code Download