A Novel U-Flap Epicanthoplasty for Asian Patients

Zan, Tao; Jin, Rui; Li, Haizhou; Herrler, Tanja; Meng, Xiangjun; Huang, Xiaolu; Li, Qingfeng; Gu, Bin

doi:10.1007/s00266-016-0665-2

Cited by 10 publications

(4 citation statements)

References 19 publications

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“…6 However, flap advancement involves the incision line perpendicular to the orbicularis oculi direction, which subsequently causes an unnatural medial canthal shape. 22 In Korea, Park's Z-plasty, V-W plasty, and skin re-draping methods are commonly used. 7, 23 Park's Z-plasty, a straightforward and reproducible method, can naturally connect its incision line to that of double eyelid surgery.…”

Section: Discussionmentioning

confidence: 99%

“…It can produce satisfactory results even in severe patients and is better suited for Asians whose epicanthal fold is usually caused by excess soft tissue in the medial canthal area 6 . However, flap advancement involves the incision line perpendicular to the orbicularis oculi direction, which subsequently causes an unnatural medial canthal shape 22 …”

Section: Discussionmentioning

confidence: 99%

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Medial Epicanthal Fold Correction Using a Y-W Epicanthoplasty in Asian Eyelids

Park,

Moon,

Kim

et al. 2024

Journal of Craniofacial Surgery

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Many surgical techniques for managing epicanthal folds have been reported, but their main drawbacks include a noticeable scar in Asians, acute medial canthal angle, and applicability only in mild or moderate epicanthal folds. This study described a novel surgical technique, Y-W epicanthoplasty, and assessed the medial canthal shape and scarring in patients who underwent Y-W epicanthoplasty. Patients with moderate or severe epicanthal folds between January 2004 and February 2017 were included in this study. Pre- and postoperative intercanthal distance (ICD), inner canthal angle (ICA), and interpupillary distance (IPD) were measured. The ICD ratios (ICD/IPD) and extent of postoperative scarring were evaluated. A Y-W epicanthoplasty was performed on 18 patients. The ICD ratio of the total study cohort showed a significant reduction following surgery (preoperative ICD ratio=0.62±0.04, postoperative ICD ratio=0.58±0.03, P<0.001). The ICA was 51.8±7.7° and 49.8±5.6° in the pre- and postoperative periods, respectively (P=0.086) Eleven patients showed no apparent scar, and 6 patients were found to have minimal scarring that was visible only under close inspection. One patient had a hypertrophic scar that was successfully managed with triamcinolone acetonide injections. Y-W epicanthoplasty can provide good aesthetic results without a visible scar in patients with moderate-to-severe epicanthal folds. The Y-W epicanthoplasty avoids a medially extended skin incision and excessive tension on the skin flaps. Moreover, an acutely shaped or webbed medial canthus after epicanthoplasty can be prevented by adding a small triangular flap. The Y-W epicanthoplasty procedure is simple and straightforward, and it is appropriate for moderate-to-severe epicanthal fold correction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medial Epicanthal Fold Correction Using a Y-W Epicanthoplasty in Asian Eyelids

Park,

Moon,

Kim

et al. 2024

Journal of Craniofacial Surgery

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“…Consequently, many individuals choose epicanthoplasty to correct this feature. Several studies on epicanthoplasty have been conducted, indicating successful outcomes (2)(3)(4)(5)(6)(7)(8)(9)(10). However, practical experience has shown complications such as excessive exposure of the lacrimal caruncle, conjunctival ectropion, and scar contracture due to overcorrection, increasing the demand for medial epicanthal fold reconstruction.…”

Section: Introductionmentioning

confidence: 99%

A comparative retrospective analysis: myocutaneous flap versus skin flap in V-Y medial epicanthal fold reconstruction

Wang,

Zhang,

Chen

et al. 2024

Front. Surg.

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ObjectivesTo evaluate the comparation of myocutaneous flap vs. skin flap in V-Y medial epicanthal fold reconstruction.MethodsThe study, conducted from April 2017 to June 2022, involved two groups: group A, comprising 21 patients who underwent medial epicanthal fold restoration surgery using the V-Y advancement method with a skin flap, and group B, comprising 83 patients who underwent the same procedure, while with a myocutaneous flap for orbicularis oculi ring reconstruction. Intercanthal distances were measured preoperatively, recorded during preoperative and postoperative reviews, and assessed through a 4-point Likert satisfaction questionnaire.ResultsA total of 104 patients were followed up for 6 months postoperatively. In group A, preoperative intercanthal distances ranged from 28.7 mm to 38.2 mm, increasing to 30.2 mm–40.6 mm postoperatively, with a mean increase of 3.0 mm (P < 0.05). In group B, preoperative distances ranged from 28.8 mm to 38.0 mm, increasing to 32.2 mm–41.5 mm postoperatively, with a mean increase of 3.9 mm (P < 0.05). Group B exhibited a higher overall satisfaction rate compared to group A.ConclusionThe myocutaneous flap V-Y procedure, employing the principle of orbicularis oculi ring reconstruction, achieves more stable postoperative results than the flap-only V-Y procedure. Consequently, it can be regarded as the preferred surgical technique.

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“…1,2 There are numerous techniques for epicanthoplasty which are usually combined with double-eyelid blepharoplasty, including Z-plasty and its modifications (transposition skin flap), V-Y and V-W skin flap (advanced skin flap), orbicularis oculi muscle resection, and medial canthal ligament placation. [3][4][5][6][7][8] These techniques mainly involve the use of subcutaneous tissue dissection and orbicularis oculi myectomy to release the vertical tension. 9 Among all the methods, Z-plasty and its modifications are the most extensively studied.…”

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confidence: 99%

Modified Z-Epicanthoplasty Based on the Movement and Tension of Medial Canthal Area in Asian Females

Tong

Wang

Sun

et al. 2021

Journal of Craniofacial Surgery

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Background: Z-epicanthoplasty is a popular method of correcting mild to moderate epicanthal folds. However, it has some limitations, such as, under correction, recurrence, and leaving of a visible scar. This study aimed to modify the traditional Z-epicanthoplasty to optimize its application in correcting severe cases of epicanthal fold. Methods: A total of 117 Asian female patients received the modified Z-epicanthoplasty between January 2018 and April 2018. The type and severity of epicanthal fold were evaluated preoperatively, whereas the intercanthal distance, interpupillary distance, and scar visibility and cosmetic results were evaluated preoperatively and 1-year postsurgery. Results: A total of 142 eyes had epicanthus tarsalis, whereas 92 eyes had epicanthus palpebralis. Of these, 29 were mild, 95 were moderate, and 119 were severe. After the operation, the intercanthal distance ratio was decreased from 0.615 (range, 0.548-0.685) preoperatively to 0.564 (range, 0.500-0.632). The mean reduction was 5.1% (range, 1.2%-10.1%; P < 0.001, Wilcoxon signed-rank test). Also, 195 eyes (83.3%) had no apparent scar and 36 (15.4%) had visible scar only under close inspection. Three eyes (1.32%) had visible scar without the need for revision. No reoccurrence was observed. And the cosmetic outcomes were scored as either excellent or good. Conclusions: The modified Z-epicanthoplasty which released the medial canthus activity sufficiently and corrected epicanthal fold at its maximum displacement is an effective method for the treatment of all degrees of epicanthus tarsalis and epicanthus palpebralis in Asian females.

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A Novel U-Flap Epicanthoplasty for Asian Patients

Abstract: 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 .

Cited by 10 publications

References 19 publications

Medial Epicanthal Fold Correction Using a Y-W Epicanthoplasty in Asian Eyelids

Medial Epicanthal Fold Correction Using a Y-W Epicanthoplasty in Asian Eyelids

A comparative retrospective analysis: myocutaneous flap versus skin flap in V-Y medial epicanthal fold reconstruction

Modified Z-Epicanthoplasty Based on the Movement and Tension of Medial Canthal Area in Asian Females

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