Advertisement

The Modified Rectangle Flap Epicanthoplasty: A Novel and Individualized Design

  • Zhe Cao
  • Yong-Qiang Guo
  • Shen-Xing Tan
  • Chang-Ying Niu
  • Jing-Han Wang
  • Chun-Lei Miao
  • Sheng-Jian TangEmail author
  • Xiao-Qin LiangEmail author
Original Article Oculoplastic
  • 43 Downloads

Abstract

Background

The epicanthal fold is ordinary in the eyelids of Asians, and the aesthetic appearance of eyelid surgery could be reduced and undermined; thus, medial epicanthoplasty is commonly performed to eliminate the effect of the epicanthal fold with less scarring. At present, there are a lot of techniques that have been described for the treatment of epicanthal fold. The potential problems, however, such as visible scar or under correction in the medial canthus area are challenges to surgeons. The purpose of our study was to explore a novel and individualized design using a modified rectangle flap with acceptable functional and aesthetic outcomes.

Methods

From January 2017 to January 2018, epicanthoplasty was performed for 40 patients by using a modified rectangle flap. All patients underwent double-eyelid surgery at the same time when they needed it. The evaluation criteria included the intercanthal distance (ICD), interpupillary distance (IPD), the ratio of ICD to IPD (ICD ratio), scar visibility, and cosmetic results.

Results

From January 2017 to January 2018, the modified rectangle flap method was carried out on 40 patients, who were evaluated at follow-up from 7 to 15 months. The average intercanthal length was 36.9 ± 2.2 mm preoperatively and decreased significantly to 31.5 ± 1.8 mm postoperatively, 7 months after the surgery (P < 0.01). The excellent cosmetic results, in terms of an open medial canthus, were observed during follow-up periods, with no definite recurrence, hypertrophic scar, or injury of the lacrimal apparatus. The inner canthus and lacrimal caruncle are fully exposed with an invisible scar. Both the patients and the surgeon judged that the aesthetic outcomes were excellent or good.

Conclusions

This modified rectangular flap is an effective and personalized method of correcting the medial folds that leave no additional scar in the medial canthal area, and the procedure meets the patient’s aesthetic expectations.

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.

Keywords

Epicanthoplasty Modified rectangle flap Invisible scar 

Notes

Acknowledgements

We thank all the authors for their efforts in this article. The PhD Start-up Fund of Weifang Medical College (2017BSQD35).

References

  1. 1.
    Hu X, Lin X, Ma G et al (2012) Two-Z-epicanthoplasty in a three-dimensional model of Asian eyelids. Aesthetic Plast Surg 36:788–794CrossRefGoogle Scholar
  2. 2.
    Lu JJ (2011) Epicanthoplasty with double eyelid plasty incorporating modified Z-plasty for Chinese patients. J Plast Reconstr Aesthet Surg 64:462–466CrossRefGoogle Scholar
  3. 3.
    Wang L, Chen X, Zheng Y (2013) A modified z-epicanthoplasty combined with blepharoplasty used to create an in-type palpebral fissure in Asian eyelids. Aesthetic Plast Surg 37:704–708CrossRefGoogle Scholar
  4. 4.
    Lee CK, Ahn ST, Kim N (2013) Asian upper lid blepharoplasty surgery. Clin Plast Surg 40(1):167–178CrossRefGoogle Scholar
  5. 5.
    Jing Z, Zuo Q, Xian Z et al (2016) A modified method combining Z-epicanthoplasty and blepharoplasty to develop out-fold type double eyelids. Aesthet Plast Surg 40:48–53CrossRefGoogle Scholar
  6. 6.
    Lyu D, Jin Y, Chang L et al (2017) The modified Z-epicanthoplasty-a stepwise and individualized design. Ann Plast Surg 78(1):7–11CrossRefGoogle Scholar
  7. 7.
    Song Z, Hong X (2018) Adjustable V-flap epicanthoplasty based on desired eyelid morphology authors authors and affiliations. Aesthet Plast Surg 42(6):1571–1575CrossRefGoogle Scholar
  8. 8.
    Lee YJ, Baek RM, Song YT et al (2006) Periciliary Y–V epicanthoplasty. Ann Plast Surg 56:274–278CrossRefGoogle Scholar
  9. 9.
    Liu Y, Lei M, Wang Y, Mu X (2012) Lazy S-curve epicanthoplasty in Asian blepharoplasty. Aesthetic Plast Surg 36:254–260CrossRefGoogle Scholar
  10. 10.
    Zeng L, Cen Y, Chen J (2017) Epicanthoplasty with epicanthal dermatic tension-releasing incision based on skin projection of inner canthal ligament. Aesthet Plast Surg 41(4):863–871CrossRefGoogle Scholar
  11. 11.
    Jing Z, Xiao G, Guo S et al (2018) Surgical outcome and patient satisfaction after Z-epicanthoplasty and blepharoplasty. Int J Ophthalmol 11(12):1922–1925Google Scholar
  12. 12.
    Park DH, Park SU, Lee BK et al (2014) Medial epicanthoplasty without a vertical scar. Ann Plast Surg 73(1):8–11CrossRefGoogle Scholar
  13. 13.
    Lai CS, Lai CH, Wu YC et al (2012) Medial epicanthoplasty based on anatomic variations. Plast Reconstr Aesthet Surg 65(9):1182–1187CrossRefGoogle Scholar
  14. 14.
    Kim CY, Lee SY (2015) Structural and cosmetic outcomes of medial epicanthoplasty: an outcome study of three different techniques. J Plast Reconstr Aesthet Surg 68:1346–1351CrossRefGoogle Scholar
  15. 15.
    Hwang K, Kim H (2016) Historical vignettes of epicanthoplasty. J Craniofac Surg 27:1080–1083CrossRefGoogle Scholar
  16. 16.
    Kakizaki H, Ichinose A, Nakano T (2012) Anatomy of the epicanthal fold. Plast Reconstr Surg 130(3):494–495CrossRefGoogle Scholar
  17. 17.
    Kim MS, Sa HS, Lee JY (2014) Surgical correction of epiblepharon using an epicanthal weakening procedure with lash rotating sutures. Br J Ophthalmol 98:120–123CrossRefGoogle Scholar
  18. 18.
    Park DH, Park SU, Ji SY et al (2013) Combined epicanthoplasty and blepharoptosis correction in Asian patients. Plast Reconstr Surg 132:510–519CrossRefGoogle Scholar
  19. 19.
    Yun J, Dongze L, Hui C et al (2017) Invisible scar medial epicanthoplasty: a novel approach. J Plast Reconstr Aesthet Surg 70(7):1–7Google Scholar
  20. 20.
    Kwon BS, Kong JS, Kim YW et al (2014) Corrective epicanthoplasty in patients with unnatural results of prior epicanthoplasty: rearrangement of the orbicularis oculi muscle above the medial canthal tendon. Ann Plast Surg 73(1):12–15CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  • Zhe Cao
    • 1
  • Yong-Qiang Guo
    • 2
  • Shen-Xing Tan
    • 3
  • Chang-Ying Niu
    • 4
  • Jing-Han Wang
    • 1
  • Chun-Lei Miao
    • 1
  • Sheng-Jian Tang
    • 1
    Email author
  • Xiao-Qin Liang
    • 1
    Email author
  1. 1.Institute of Plastic SurgeryWeifang Medical UniversityWeifangPeople’s Republic of China
  2. 2.Department of OrthopedicsThe Eighty-Ninth Hospital of People’s Liberation ArmyWeifangPeople’s Republic of China
  3. 3.Department of Plastic SurgeryAffiliated Hospital of Weifang Medical UniversityWeifangPeople’s Republic of China
  4. 4.Department of DermatologyAffiliated Hospital of Weifang Medical UniversityWeifangPeople’s Republic of China

Personalised recommendations