As mentioned in the previous blog, the medial canthus can be classified into four types depending on the presence and absence of epicanthal folds and the types of epicanthal folds. Obviously, people with type I do not need epicanthoplasty, whereas type II to IV have variable amount of epicanthal folds which can benefit from epicanthoplasty. However, the effect of epicanthoplasty on the width depends very much on the extent of the epicanthal folds with the results being most obvious in type III and type IV (see picture below).
The pictures show the pre- and postoperative epicanthoplasty (+ double eyelid surgery
in type II and III). The most obvious changes to the width of the eye are most noted
in type III and IV.
In the rare cases of blepharophimosis with type IV epicanthal folds, the patients often appear to have a less intelligent facies then they actually are. Many of these patients got bullied at school for their appearances, early operations to lengthen the eyes and correct the ptosis can have a dramatic effect on the patients' well-beings.
The above pictures show a 7 year-old girl who underwent blepharophimosis
correction with epicanthoplasty and frontalis slings.