Medial Epicanthoplasty Using a Lower Palpebral Margin Incision Combined With a Tiny Triangular Flap.

OBJECTIVE: The incidence of epicanthus is extremely high in Asians. Although many techniques have been introduced to remove the epicanthus, there are still some complications. Herein, we introduced a method involving an incision on the lower palpebral margin combined with a tiny triangular flap for correction of epicanthal folds, which is always performed in combination with double eyelid plasty. METHODS: After making an incision, the ectopic medial canthal ligament was removed. The ligament pulling the medial canthus was cut along the lower palpebral margin incision, so the medial canthus could be repositioned upward. The tiny triangular flap of the medial canthus would naturally move downward and cover the lower palpebral margin incision. The skin folds on the lower palpebral margin were trimmed and sutured. After epicanthoplasty was completed, double eyelid plasty was performed using the incision or non-incision method. RESULTS: A total of 547 epicanthoplasties were performed during the past 7 years. The follow-up time ranged from 1 month to 5 years. Ninety-eight percent of the patients were satisfied with the results of the epicanthoplasty. The scars in the medial canthal area were tiny, the enlargement of the medial canthus was obvious, and the double eyelid line in the medial canthal area was natural and smooth. CONCLUSION: The introduced method is simple in design and can preserve the original shape of the medial canthus while widening the palpebral fissure, which is a particularly suitable approach for epicanthoplasty in Asian patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .