Epikanthal folds causing small eyes are relatively common among Asians. Their primary characteristic is a webbed fold above the inner corner of the eye, partially or fully obscuring the inner canthus and affecting aesthetics. The presence of this fold not only widens the distance between the inner canthi and flattens the nasal bridge but also partially obstructs vision, impairing visual function.Epikanthal folds can be classified as congenital or acquired. Congenital cases are more prevalent clinically. Congenital epikanthal folds are typically bilateral, exhibit a degree of hereditary predisposition, and may occasionally be associated with anomalies such as ptosis or small palpebral fissures.Acquired epicanthal folds often result from trauma, burns, or other injuries, frequently accompanied by damage to adjacent tissues.
Epicanthoplasty can treat epicanthal folds.
The Z-plasty technique is the optimal surgical method for correcting mild to moderate epicanthal folds. It primarily extends the epicanthal fold margin through Z-plasty, thereby correcting the fold.
Optimal Timing for Epicanthal Folds Surgery
Surgical correction is the primary treatment for epicanthal folds. Since childhood is a period of rapid growth and development, with the nasal bridge gradually increasing in height and the protrusion of the eyeballs becoming more pronounced, the degree of epicanthal folds tends to diminish over time. Therefore, the recommended age for surgery is generally after 10 years old.Patients with excessively wide inner canthi are particularly suitable candidates for this procedure.
Preparing for Canthoplasty
Although canthoplasty is not a major surgery, thorough communication with your surgeon beforehand is essential to determine the optimal surgical plan. Your doctor will provide detailed preoperative instructions, including dietary guidelines, smoking restrictions, and specific vitamins and medications to take or avoid.Please follow these instructions carefully, as they will significantly contribute to the success of your surgery.
Eyelid Surgery Procedure
First, with the patient's eyes naturally open and looking straight ahead, the surgeon identifies the starting and ending points of the epicanthal fold. These points are marked with gentian violet. Local infiltration anesthesia using 2% lidocaine is administered. The patient closes their eyes while the surgeon makes an incision along the pre-designed line through the skin and orbicularis oculi muscle. The skin flap is thoroughly dissected. The patient is then asked to open their eyes.to assess the correction of the epicanthal fold. After exchanging the paired triangular flaps, they are sutured into place, completing the procedure.
Postoperative Care for Epicanthoplasty
Although vision remains unaffected after epicanthoplasty, excessive eye strain can hinder swelling reduction. Therefore, it is recommended to minimize eye-related activities postoperatively.Rest for approximately one week and follow your doctor's instructions for local cleansing (using saline solution). Avoid vigorous rubbing of the eyes. Sutures are typically removed around 5 days post-surgery. During the recovery period, avoid or minimize consumption of spicy foods.