Traditionally, large eyes have been regarded as a standard of beauty. To enhance their appearance, some individuals opt for this cosmetic procedure, while others remain hesitant due to lack of understanding. To help everyone gain a proper understanding of epicanthoplasty, let's hear from an expert about the relevant knowledge.
I. Who is suitable for epicanthoplasty?
1.Eyelid surgery is suitable for those with small eyes: It significantly widens the palpebral fissure, creating a slender and elegant eye shape;
2. It is also suitable for those with dull-looking eyes: Opening the inner canthus makes the eyes appear bright and radiant;
3. Those seeking continuous improvement of their double eyelids: Eyelid surgery can be performed concurrently with double eyelid surgery to create alluring almond-shaped eyes;
4. Individuals with wide-set eyes: Removing epicanthal folds and enlarging the inner canthus effectively narrows the distance between eyes. This procedure also effectively corrects such cases;
5. The surgery can provide some improvement for drooping eye corners. If combined with ptosis, ptosis correction surgery can be performed 6 to 12 months later for comprehensive treatment.
II. Steps of Eyelid Surgery
1. Preoperative Planning
Meticulous preoperative planning is crucial for surgical success. This begins with thorough communication with the patient to understand their expectations, followed by marking the incision lines based on the surgeon's expertise.
2. Local Anesthesia
After marking the incision lines, local anesthesia is administered.Under anesthesia, the patient experiences minimal discomfort during the procedure, with only slight sensations during incision and suturing comparable to needle pricks—generally tolerable for most individuals.
3. Incision and Adjustment
Following the preoperative plan, the surgeon makes a full-thickness horizontal incision along the lateral canthus using scissors, extending through the skin and conjunctiva.From the conjunctival incision, blunt dissection is performed nasally and superiorly to release the bulbar conjunctival dome. The horizontal bulbar conjunctiva is pulled to the apex of the incised lateral canthus and secured with one suture. The superior and inferior dome conjunctiva are then interrupted sutured to the incised skin. If necessary, the lateral canthal ligament is partially or completely transected.At the newly formed lateral canthus, perform a mattress suture through the conjunctiva. Exit the needle at the skin surface of the lateral canthus and tie it to a gauze pad to form the (temporal) lateral fornix. When suturing conjunctiva to skin, if conjunctival tension is excessive, vertically incise the bulbar conjunctiva between the lateral cornea and lateral canthus to reduce tension.
Have the patient open their eyes to assess the correction of the epicanthal fold. Repeatedly compare both eyes for symmetry and shape suitability, making precise adjustments to achieve the most satisfactory outcome. Upon completion, apply antibiotic ointment into the conjunctival sac to prevent adhesions.
4. Suturing
Using 5/0 silk suture, place the first stitch at the junction of the medial and middle thirds of the upper eyelid—the widest part of the palpebral fissure. Insert the needle through the skin at the lower edge of the incision, then pass it through the aponeurosis of the tarsal plate 1 mm below its superior margin. Exit the needle at the upper skin margin of the incision.Form a loose knot. Have the patient open their eyes to assess the width of the upper eyelid crease and check for swelling or excessive tension in the lower skin margin of the incision.
Experts indicate that for individuals with small eyes, epicanthoplasty can achieve ideal corrective results.Eyelid surgery involves both medial and lateral approaches. To correct small eyes, both the medial and lateral canthi must be widened. When necessary, medial canthal ligament fixation may be performed to correct widened orbital distance, or ptosis correction surgery may also be required.Congenital small eyes, characterized by narrow palpebral fissures, severe epicanthal folds, and often accompanied by widened epicanthal distance and ptosis, require staged surgical intervention. While the procedure involves both inner and outer approaches, the specific technique is not solely determined by the patient's preference but is decided by a professional surgeon based on the unique characteristics and condition of the eyes.
III. Postoperative Care for Eyelid Surgery
1. Avoid getting the surgical area wet for 7 days post-surgery;
2. Maintain cleanliness to prevent infection. If scabs or secretions form, gently wipe with sterile saline solution.
3. Apply light pressure bandaging or cold compresses to the wound, but avoid excessive pressure to prevent eye injury.If uncontrolled bleeding or severe hematoma occurs, seek immediate medical attention;
4. Mild pain at the incision site is normal on the day of surgery but will gradually subside. Avoid taking painkillers hastily, as aspirin-based medications may increase bleeding;
5. Rest in a quiet, comfortable environment post-surgery.Avoid watching TV or reading newspapers for 2 weeks post-op. When resting in bed, maintain a semi-reclined position (elevate with pillows) to prevent eye strain or excessive swelling from a low head position. 6. Avoid consuming irritating foods like chili peppers. 7. Strictly follow the doctor's instructions for medication and follow-up appointments.