Aesthetic Plastic Surgery

, Volume 41, Issue 4, pp 863–871 | Cite as

Epicanthoplasty with Epicanthal Dermatic Tension-Releasing Incision Based on Skin Projection of Inner Canthal Ligament

  • Linghuan ZengEmail author
  • Ying Cen
  • Junjie Chen
  • Lei Lei
Original Article Oculoplastic



Epicanthoplasty is a reconstructive procedure that eliminates the deformity of the epicanthal fold and provides a more esthetic inner canthus. The epicanthal tension-releasing incision is a core technique of epicanthoplasty. However, which epicanthal dermatic tension-releasing incision most effectively provides epicanthal tension release remains unclear. We designed a novel dermatic tension-releasing incision based on the skin projection of the inner canthal ligament and compared it with the more conventional incision parallel to the lower inner canthal mucocutaneous junction (white line).


From December 2014 to March 2016, 30 patients were divided into two groups according to the type of dermatic tension-releasing incision. Each group comprised 15 patients and 30 eyes. In Group A, incision line a was performed (tension-releasing incision parallel to the lower inner canthal mucocutaneous junction, 4–5 mm away from the mucocutaneous junction). In Group B, incision line b was performed (tension-releasing incision pointed toward the lacrimal lake, along the skin projection of the inner canthal ligament). The defect angles of the two groups were photographed intraoperatively after tension release and analyzed postoperatively.


The defect angles in Group B were significantly larger than group A (P < 0.0001). All patients obtained an esthetically pleasing inner canthus without hypertrophic scarring or injury to the lacrimal apparatus during the 3- to 24-month follow-up period.


An epicanthal dermatic tension-releasing incision based on the skin projection of the inner canthal ligament is more effective and safer than an incision parallel to the lower inner canthal mucocutaneous junction.

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


Epicanthoplasty Blepharoplasty Dermatic tension-releasing incision Epicanthal fold 


Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

All procedures performed in 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.

Supplementary material

Video 1 Surgical procedure of Group A (WMV 92872 kb)

Video 2 Surgical procedure of Group B (WMV 172485 kb)


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Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2017

Authors and Affiliations

  1. 1.Department of Burn and Plastic Surgery, West China HospitalSichuan UniversityChengduPeople’s Republic of China

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