Restoration of the medial epicanthal fold: reverse skin redraping method in patients unsatisfied with epicanthoplasty

Ann Plast Surg. 2013 Nov;71(5):456-60. doi: 10.1097/SAP.0b013e31824e5e36.

Abstract

Background: Many Asians receive epicanthoplasty to improve their medial epicanthal fold.Excessive performance of such surgery may cause multiple unwanted results, but there is no report on any restoration method for an overcorrected result of epicanthoplasty. Accordingly, the authors have created a new method for reversely restoring the excessively corrected medial epicanthal fold using skin-redraping epicanthoplasty (Plast Reconstr Surg. 2007;119:703-710).

Methods: During the interval between January 2009 and April 2011, 35 patients received surgery for restoration of the epicanthal fold using the authors' method, which involves sufficiently elevating the skin flap and redraping it to reconstruct the epicanthal fold. This method is very simple to design and perform, and it effectively covers the excessively exposed lacrimal lake. In addition, it can be used independently of the type of prior epicanthoplasty.

Results: After the surgery, 2 patients experienced overcorrection, and we repeated the epicanthoplasty. In the other patients, there was no severe complication except for mild redness, a condition that improved after several months. The mean measured distance between the medial canthi after the surgery was 36.8 mm, corresponding to a total lengthening effect of 4.5 mm. This improved the aggressive facial expression caused by the exposed lacrimal lake, and the eyes no longer appeared to be too close together. Moreover, in the case of patients who had more visible scars due to prior epicanthoplasty on the medial epicanthal area, the overall scar length decreased.

Conclusions: This method is simple in design and easy to perform. It can also control the degree of restoration with an additional advantage of reducing a prior scar. Using this method, we could effectively restore the overcorrected epicanthal fold.

MeSH terms

  • Adult
  • Asian People
  • Blepharoplasty / adverse effects*
  • Blepharoplasty / methods
  • Cicatrix / etiology
  • Cicatrix / prevention & control
  • Eyelids / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Patient Satisfaction*
  • Postoperative Complications / surgery*
  • Reoperation
  • Treatment Outcome
  • Young Adult