The Footplates Reposition Technique for Improving Tip Stability, Balancing Columellar-Labial Junction, and Upper Lip Lifting.

Abstract

The footplates of the medial crura are relevant structures that play an important role in the columella and nostril sill design. They also work as a connection between the nasal and oral muscles, as the insertion of the superficial orbicularis oris nasalis (SOON) is placed into the footplates and the continuation of the superficial muscular aponeurotic system (SMAS) is situated within the membranous septum. Moreover, the SOON is a powerful depressor of the nasal tip.Many techniques attempt to reconstruct the tip support with grafts, but footplates and their connections can play an important role.We describe a surgical technique that involves footplate release and repositioning for better sill design, improvement of tip support and stability, better balance of the columellar-labial junction (CLJ), upper lip lifting, and eversion of the vermilion.This retrospective study reviewed the medical records of 64 patients who underwent all steps described in the paper.The patients were followed up for 12 months and decreases in philtrum length were accompanied by an enhanced vermilion showing creating a more favorable balance.The footplate release and repositioning technique can be incorporated as an adjunct in rhinoplasty to provide additional tip support, facilitate nasolabial angle adjustment, and assist in upper lip repositioning.