Abstract
Background
The epicanthal fold is a distinct characteristic of the Asian upper eyelid, which may impair the beauty of the eyes and the outcome of double eyelid blepharoplasty. Although many surgical procedures have been reported, their main drawbacks include a conspicuous scar in the medial canthal area and an unnatural palpebral contour. We devised a novel surgical approach to correct the epicanthal fold with acceptable scarring.
Methods
From June 2011 to October 2014, U-flap epicanthoplasty was performed on 118 Chinese patients in our department. The U-flap was designed on the medial canthal skin. After complete dissection of the flap from the dislocated orbicularis muscle and underlying connective tissue, the flap naturally rotated upward to a line consistent with the direction of the palpebral fold. The flap was then subcutaneously fixed to the medial part of the medial canthal ligament. Finally, the redundant skin was trimmed off and the incision was sutured without tension. Patients were evaluated before and 12 months after surgery.
Results
The average decrease in the intercanthal distance was 4.36 ± 0.32 mm. The general satisfaction rate was 97.5 %. Three patients showed bilateral hypertrophic scar formation on both bilateral medial canthal incisions and palpebral incisions; however, the scarring subsided after three triamcinolone acetonide injections. No epicanthal fold recurrence or other complications were observed during the 12-month follow-up period.
Conclusion
U-flap epicanthoplasty is a simple and effective method for elimination of types I–III epicanthal folds. However, its long-term effects require further study.
Level of Evidence V
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References
Mustarde JC (1963) Epicanthus and telecanthus. Br J Plast Surg 16:346
Yoon KC (1993) Modification of Mustarde technique for correction of epicanthus in Asian patients. Plast Reconstr Surg 92:1182
Von Ammon FA (1841) Klinische Darstellungen der Angoborenen: Krankheiten und Bildungstehler des Menschlichen der Auges und Augenlider. Editorial. G. Reimer, Berlin
Kao YS, Lin CH, Fang RH (1998) Epicanthoplasty with modified Y–V advancement procedure. Plast Reconstr Surg 102:1835–1841
Kao YS, Lin CH, Fang RH (1998) Epicanthoplasty with modified YV advancement procedure. Plast Reconstr Surg 102(6):1835–1841
Park JI (1996) Z-epicanthoplasty in Asian eyelids. Plast Reconstr Surg 98:602
Fujiwara T, Maeda M, Kuwae K et al (2006) Modified split V–W plasty for entropion with an epicanthal fold in Asian eyelids. Plast Reconstr Surg 118(3):635–642
Zhang H, Zhuang H, Yu H et al (2006) A new Z-epicanthoplasty and a concomitant double eyelidplasty in Chinese eyelids. Plast Reconstr Surg 118(4):900–907
Liu Y, Lei M, Wang Y, Mu X (2012) Lazy S-curve epicanthoplasty in Asian blepharoplasty. Aesthet Plast Surg 36(2):254–260
Lee Y, Lee E, Park WJ (2000) Anchor epicanthoplasty combined with out-fold type double eyelidplasty for Asians: do we have to make an additional scar to correct the Asian epicanthal fold. Plast Reconstr Surg 105(5):1872–1880
Duke-Elder S (1954) Textbook of ophthalmology. Br Med J 1(4866):859
Wang S, Shi F, Luo X, Liu F, Zhou X, Yang J, Yang Q, Wang X (2013) Epicanthal fold correction: our experience and comparison among three kinds of epicanthoplasties. J Plast Reconstr Aesthet Surg 66(5):682–687
Park DH, Choi WS, Yoon SH, Song CH (2008) Anthropometry of Asian eyelids by age. Plast Reconstr Surg 121:1405–1413
Hu X, Lin X, Ma G, Jin Y, Chen H, Chen X, Ye X, Qiu Y (2012) Two-Z-epicanthoplasty in a three-dimensional model of Asian eyelids. Aesthet Plast Surg 36(4):788–794
Liu Y, Huang J, Wen K (2011) A modified and accurately designed Z-epicanthoplastic technique. Aesthet Plast Surg 35(6):1112–1116
Shin YH, Hwang PJ, Hwang K (2012) V–Y and rotation flap for reconstruction of the epicanthal fold. J Craniofac Surg 23(4):278–280
Liu L, Li S, Fan J, Gan C, Tian J, Jiao H, Feng S (2012) Inverted ‘V–Y’ advancement medial epicanthoplasty. J Plast Reconstr Aesthet Surg 65(1):43–47
Cho BC, Lee KY (2002) Medial epicanthoplasty combined with plication of the medial canthal tendon in Asian eyelids. Plast Reconstr Surg 110(1):293–300
Park DH, Park SU, Ji SY et al (2013) Combined epicanthoplasty and blepharoptosis correction in Asian patients. Plast Reconstr Surg 132(4):510–519
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The authors declare that they have no conflicts of interest.
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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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All participants gave their informed consent in writing prior to inclusion in the study.
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Tao Zan and Rui Jin contributed equally to the acquisition, analysis, and treatment of data, and should be viewed as co-first authors.
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Zan, T., Jin, R., Li, H. et al. A Novel U-Flap Epicanthoplasty for Asian Patients. Aesth Plast Surg 40, 458–465 (2016). https://doi.org/10.1007/s00266-016-0665-2
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DOI: https://doi.org/10.1007/s00266-016-0665-2