The Modified Rectangle Flap Epicanthoplasty: A Novel and Individualized Design

Area of Science:

• Oculoplastic surgery
• Facial plastic surgery
• Aesthetic surgery

Background:

• Epicanthal folds are common in Asian eyelids, potentially affecting aesthetic outcomes of eyelid surgery.
• Medial epicanthoplasty aims to reduce epicanthal folds with minimal scarring.
• Existing techniques may present challenges like visible scars or undercorrection.

Purpose of the Study:

• To explore a novel, individualized technique for medial epicanthoplasty.
• To evaluate functional and aesthetic outcomes of a modified rectangle flap design.

Main Methods:

• A modified rectangle flap technique was used for medial epicanthoplasty in 40 patients from January 2017 to January 2018.
• Patients also underwent concurrent double-eyelid surgery if indicated.
• Outcomes were assessed using intercanthal distance (ICD), interpupillary distance (IPD), ICD ratio, scar visibility, and cosmetic results.

Main Results:

• The modified rectangle flap significantly reduced intercanthal length (36.9 mm to 31.5 mm) in 40 patients.
• Follow-up (7-15 months) showed excellent cosmetic results, including an open medial canthus with no recurrence or hypertrophic scarring.
• The inner canthus and lacrimal caruncle were fully exposed with an invisible scar, meeting patient and surgeon satisfaction.

Conclusions:

• The modified rectangular flap is an effective and personalized method for correcting medial epicanthal folds.
• This technique results in no additional scar in the medial canthal area.
• The procedure successfully meets patient aesthetic expectations.