Medial Epicanthoplasty

Nowadays, we have the opportunity to change almost any feature of our body and facial appearance, whether it is functional or aesthetic. Medicine and cosmetic surgeries are advancing at a rapid pace, and many individuals proceed with different procedures to correct a specific part of their body that they are not satisfied with. Thanks to plastic surgery, you can improve your bust, thighs, stomach, nose, and appearance of your eyes.

Without a doubt, we can say that double eyelid surgery is one of the most desired procedures in Singapore. However, epicanthoplasty is a type of eyelid surgery that also has become very popular in recent years.

What is epicanthoplasty?

Epicanthoplasty is a surgical procedure that allows patients to improve the appearance of their eyes significantly, hence their self-confidence. Here are some quick facts about this cosmetic procedure.

• It is undertaken to create a visual appearance of wider and larger eyes.
• This plastic surgery is typically performed under local anaesthesia.
• The recovery is rapidly fast.
• It is a very safe eye surgery with a high success rate.
• Medial epicanthoplasty is suitable for patients who have an epicanthic, Mongolian fold of the inner eyelid or patients with blepharophimosis. These features are commonly seen in Asian patients.

There are two types of epicanthoplasty procedures – medial epicanthoplasty, where the inner corner of the upper eyelid is corrected, and lateral epicanthoplasty that addresses the outer corner of the eyes. Both surgical techniques are available at Shens Clinic. Here we will focus mostly on the medial epicanthoplasty procedure.

What are the characterising features of the epicanthic fold?

Epicanthic fold is a skin fold that comes down across the inner angle of the upper eyelid. It makes the eyes appear smaller and slanted. Such a fold of skin is often observed in individuals of Asian descent. The characteristic features of epicanthal folds include:

• Wide distance between the eyes
• Eyes that have a beaked shape that has a hook pointing downwards
• Eyes that have a tapered double eyelid fold arising from the inner corner
• Occasionally some will have eyelashes growing within the fold
• Some folds are prominent and have a “U” shape from the upper to the lower eyelid
• The caruncle of the inner eye or the pink portion of the inner eye is often hidden.

What is considered to be the aesthetic ideal?

The procedure is commonly carried out to elongate the palpebral fissure, which is often dependent on proportions between the eyelid and space between the eyes. The elliptic space is often wider than the width of the eye. The aesthetic ratio is universally accepted as an eye width between the eyes.

To achieve this coveted ratio, different methods have been described. Medical literature is rife with many different techniques. Does it then mean that all these techniques yield the same results? The answer is no.

Some of these techniques have only been described to gain publications in prestigious journals.

How is medial epicanthoplasty surgery done?

Medial epicanthoplasty surgery can modify the epicanthic folds or Mongolian folds. Further, making the eyes appear bigger and wider. The procedure is also called inner corner fold removal. The most common candidates for epicanthoplasty are patients with an existing Mongolian fold and elongated medial canthal ligament.

Many techniques can be used to perform epicanthoplasty surgery. However, the basic steps of the procedure consist of:

• Pre-operative examination and assessment where the surgeon determines the condition of your epicanthic fold
• Numbing of the treated area
• Planning and marking of the upper eyelid incision
• Making cuts around the inner corner of the eyes
• Restructuring the shape of the inner eyelid and removing excess skin
• Closing of the incisions.

Medial epicanthoplasty is commonly done together with double eyelid surgery to create a visible double eyelid crease and further enhance the appearance of the eyes.

Redraping technique – the preferred method

One of the most prefered methods for medial epicanthoplasty among surgeons is the so-called redraping technique. Some Korean websites refer to this as “magic epicanthoplasty”. The skin redraping method is the newest medial epicanthoplasty technique that uses a palpebral margin incision. It allows the surgeon to hide the scar within the inner fold of the eyelid so that it does not show up in the medial canthal region.

While in the past, the aim of the surgery was the cutting of the outer eyelid skin, today, the doctors use the redraping technique to relax the muscles beneath to achieve the desired appearance. This latest method offers benefits such as shorter incisions, less visible scarring, and less or no ligature to the medial canthal ligament, thereby minimising wound tension.

For more harmonious results, epicanthoplasty is often performed as an additional procedure to double eyelid surgery.

What is the recovery from medial epicanthoplasty?

The recovery time from medial epicanthoplasty is usually between 7 and 10 days. It is important to note that the recovery period sometimes varies for different individuals.

Immediately after your surgery, your eyes will be bruised and swollen, and that may continue for a few days. You can apply ice packs to your eyes in order to minimise the swelling. It is also normal if you have blurry vision during the first day. It is usually caused by the antibiotic ointments that the surgeon applies in order to protect your eyes. The ointment will wear away over the course of the day, and your vision will get better. A little discomfort after epicanthoplasty is common. However, if you need, you can take some painkillers to manage the pain.

You will need to refrain from strenuous activity for 2 weeks after surgery. 

Avoid rubbing or scratching the treated region of your eyes as it may hinder the recovery process. Thus, gently tap or pad down the treated area with a cotton pad if you need to. After two weeks you can return to your normal activities. In case you wear contact lenses, the surgeon may advise you to avoid them for several days to promote wound healing.

What are the possible risks and side effects of epicanthoplasty?

If performed by an experienced and qualified plastic surgeon epicanthoplasty is a safe procedure that yields a high rate of success. However, like any invasive procedure, there is a possibility of complications and side effects. Here are some possible risks that you need to be aware of.

• Visible scar. Although the surgeon uses modern techniques to hide the incisions, there is still a risk of scarring. Initially, scars may be apparent for 2-3 months, and then they may gradually disappear.
• Disappointing outcomes and requirement of revision surgery. This problem can be prevented by making sure that you choose a board-certified plastic surgeon who has extensive experience in the field.
• Bleeding and infections are very rare complications.

Epicanthoplasty is simple plastic surgery, and most patients do very well with it without experiencing any complications.

The benefits of getting epicanthoplasty with double eyelid surgery

The most obvious benefit of getting both procedures at the same time is that they will make your eyes appear bigger hence more beautiful. The combination of epicanthoplasty and double eyelid surgery can widen the eyes and create a more distinctively appealing look of the eye. Those procedures will also improve your overall appearance, making you look more youthful and refreshed.