Thursday, February 25, 2016

Doc, Do I Need Operation on My Epicanthal Fold (aka epicanthoplasty, 開眼角) ? - Part 5

There are over 30 methods described for the correction of epicanthus. Some are more complicated than the others, however, the results of the complicated ones are by mean superior than the simpler ones. In addition,  surgery on the inner canthal region is prone to skin contracture and scarring and therefore a method that combines the least number of cutting and cut near the lid margin is preferred. 

Some of the epicanthoplasty described are shown below (from Asian Facial Cosmetic Surgery). 

Blair method.

Converse method.

Arlt method.

Hiraga method.

Rogeman mthod.

V-W advancement method.

W-plasty method.

Y-V method.

Mustarde method.

Park Z-plasty method.

Correction of type IV epicanthal folds in blepharophimosis. The picture on the left 
was done with Y-V method showing minimal scarring whereas the one shown on 
the right was corrected with Mustarde method showing significant skin 
contracture and scarring. Pictures taken from an article discussing
the various methods of epicanthoplasty.

My preferred methods for type II and type III epicanthal folds are Park-Z plasty and skin redraping methods. The later will be described in the next blog.

Type III epicanthal fold corrected with Park-Z epicanthoplasty.


  1. Hi Dr Chua,

    Thank you for this super informative blog! I've read nearly every single post related to double eyelid surgery as I am considering going for it. I have type 2 epicanthal folds and one eye with a tapered double eyelid and one eye with a monolid.

    I have a few questions that I hope you do not mind answering.

    Firstly, how do you decide if a patient should have parallel or tapered eyelids? Is it up to the patient's choice or would you advise depending on the eye shape and overall features?

    Secondly, I have gone for a consultation and the surgeon told me that to have a parallel eyelid, I would have to do epicanthoplasty. However I have seen many people who have done just upper blepharoplasty to get parallel lids. Is epicanthoplasty necessary for parallel lids? Or does it depend on the original condition of each patient's eye? For example, my epicanthal folds are more pronounced hence the need for epicanthoplasty to get parallel lids.

    Thank you!

  2. Hello,
    1st. Whether parallel or tapering skin creases are very much up to the patient's preference. However, it is worth noting that it is difficult to reverse parallel creases but easier to convert tapering creases to parallel creases.
    2nd. Epicanthoplasty is usually incooperated into the creation of parallel creases otherwise the creases may become tapering. For type II epicanthal folds, epicanthoplasty does not usually add much to the width of the eyes.

  3. Hi Dr Chua! Thank you for your reply!

    I was wondering what is your take on magic epicanthoplasty/devolution epicanthoplasty/Kwon's method? Is this the skin redraping method mentioned in the next post?

    Thank you!

  4. The techniques you mentioned are modifications of skin redraping techniques, a bit of extra cuts and there you can name the technique whichever way you want ;)

  5. So I want to turn my eyes into Caucasian eyes like one of the Japanese patients. Do you do that where do I go?