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A Modified Method Combining Z-Epicanthoplasty and Blepharoplasty to Develop Out-Fold Type Double Eyelids

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Abstract

Background

The epicanthus can weaken the effect of blepharoplasty, which makes it difficult to form the out-fold type double eyelids preferred by Asian women. The integration of blepharoplasty and Z-epicanthoplasty has become increasingly popular. Although many techniques have been introduced to remove the epicanthus during blepharoplasty, there are still some surgical complications.

Method

This study aimed to evaluate the practicability and effectiveness of combining Z-epicanthoplasty and blepharoplasty. Removing a slice of skin from the upper eyelid to the inner canthus makes the epicanthus crease along the vertical axis of Z-plasty. The up-outward triangular flap points to the lower eyelid margin instead of the inner canthus. By cutting off the fibrous tissue and orbicularis oculi muscle, the tension that causes epicanthus is completely released; therefore, the inner canthus ligament anchor is unnecessary and avoids damage to the inner canthus.

Result

From January 2008 to June 2014, this modified surgical method was carried out on 1108 patients. One hundred and twelve patients were evaluated at a follow-up visit ranging from 6 to 72 months. In 2 cases, the double-eyelid fold developed into an in-fold type, while, in 110 cases, it developed into an out-fold type. The outlines of the upper eyelids were natural and symmetric, and the inner canthus and lacrimal caruncle were fully exposed with no visible scar.

Conclusion

This modified method is simple in design and practice. The inner canthus and lacrimal caruncle can be fully exposed, giving a natural, smooth, Westernized, appealing look. This technique is suitable for all types of epicanthus in Asian women.

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.

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References

  1. 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 37:704–708

    Article  CAS  PubMed  Google Scholar 

  2. Lee Y, Lee E, Park WJ (2000) Anchor epicanthoplasty combined with out-fold type double eyelidplasty for Asians: do we have to make an additional scar to correct the Asian epicanthal fold? Plast Reconstr Surg 105:1872–1880

    Article  CAS  PubMed  Google Scholar 

  3. Mustarde JC (1963) Epicanthus and telecanthus. Br J Plast Surg 16:346–356

    Article  CAS  PubMed  Google Scholar 

  4. Li FC, Ma LH (2008) Double eyelid blepharoplasty incorporating epicanthoplasty using Y-V advancement procedure. J Plast Reconstr Aesthet Surg 61:901–905

    Article  CAS  PubMed  Google Scholar 

  5. Liu L, Li S, Fan J et al (2012) Inverted ‘V–Y’ advancement medial epicanthoplasty. J Plast Reconstr Aesthet Surg 65:43–47

    Article  PubMed  Google Scholar 

  6. Uchida J (1962) A surgical procedure for blepharoptosis vera and for pseudo-blepharoptosis orientalis. Br J Plast Surg 15:271–276

    Article  CAS  PubMed  Google Scholar 

  7. Liu Y, Lei M, Wang Y, Mu X (2012) Lazy S-curve epicanthoplasty in Asian blepharoplasty. Aesthetic Plast Surg 36:254–260

    Article  PubMed  Google Scholar 

  8. Mulliken JB, Hoopes JE (1975) W-epicanthoplasty. Plast Reconstr Surg 55:435–438

    Article  CAS  PubMed  Google Scholar 

  9. Lu JJ, Yang K, Jin XL et al (2011) Epicanthoplasty with double eyelidplasty incorporating modified Z-plasty for Chinese patients. J Plast Reconstr Aesthet Surg 64:462–466

    Article  PubMed  Google Scholar 

  10. Zhang H, Zhuang H, Yu H et al (2006) A new Z-epicanthoplasty and a concomitant double eyelidplasty in Chinese eyelids. Plast Reconstr Surg 118:900–907

    Article  CAS  PubMed  Google Scholar 

  11. Cho BC, Lee KY (2002) Medial epicanthoplasty combined with plication of the medial canthal tendon in Asian eyelids. Plast Reconstr Surg 110:293–300 discussion 301

    Article  PubMed  Google Scholar 

  12. Kao YS, Lin CH, Fang RH (1998) Epicanthoplasty with modified Y-V advancement procedure. Plast Reconstr Surg 102:1835–1841

    Article  CAS  PubMed  Google Scholar 

  13. Park JI (1996) Z-epicanthoplasty in Asian eyelids. Plast Reconstr Surg 98:602–609

    Article  CAS  PubMed  Google Scholar 

  14. Yoo WM, Park SH, Kwag DR (2002) Root z-epicanthoplasty in asian eyelids. Plast Reconstr Surg 109:2067–2071 discussion 2072–2063

    Article  PubMed  Google Scholar 

  15. Chen W, Li S, Li Y, Wang Y (2009) Medial epicanthoplasty using the palpebral margin incision method. J Plast Reconstr Aesthet Surg 62:1621–1626

    Article  PubMed  Google Scholar 

  16. Oh YW, Seul CH, Yoo WM (2007) Medial epicanthoplasty using the skin redraping method. Plast Reconstr Surg 119:703–710

    Article  CAS  PubMed  Google Scholar 

  17. Lee KM, Choung HK, Kim NJ et al (2010) Prognosis of upper eyelid epiblepharon repair in down syndrome. Am J Ophthalmol 150(476–480):e471

    Google Scholar 

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Authors and Affiliations

  1. Department No. 16. of Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33 Ba-Da-Chu Road, Shi Jing Shan District, Beijing, 100144, People’s Republic of China

    Jingyi Zhao, Zuoliang Qi, Xianlei Zong, Xiaonan Yang, Guodong Song, Le Du & Xiaolei Jin

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  1. Jingyi Zhao
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  2. Zuoliang Qi
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  3. Xianlei Zong
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  4. Xiaonan Yang
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  5. Guodong Song
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  6. Le Du
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  7. Xiaolei Jin
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Correspondence to Xiaolei Jin.

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None of the authors has any commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this article.

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Zhao, J., Qi, Z., Zong, X. et al. A Modified Method Combining Z-Epicanthoplasty and Blepharoplasty to Develop Out-Fold Type Double Eyelids. Aesth Plast Surg 40, 48–53 (2016). https://doi.org/10.1007/s00266-015-0604-7

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  • DOI: https://doi.org/10.1007/s00266-015-0604-7

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