Reconstruction of Medial Epicanthal Fold Using Dual-Plane V-Y Advancement Flap

Medial epicanthoplasty is a common method for correcting epicanthal folds in Asians but can lead to many complications. There are a number of techniques currently used for correction of these complications, but they often lead to incomplete correction or exacerbate the issue.

The purpose of this study is to introduce a dual-plane V-Y advancement flap method for the reconstruction of epicanthal folds that addresses both muscle reconstruction and soft tissue redraping, which we believe is key to a successful outcome, that is easy to perform, has a short learning curve, and provides excellent aesthetic results.

The study included 66 patients who experienced complications after medial canthoplasty and underwent correction using our method from January 2017 to December 2018. Patients were surveyed to assess their satisfaction with surgical outcomes. In addition, the interepicanthal distance-lengthening ratios and symmetry of palpebral widths were compared to obtain a more objective comparison before and after the corrective procedure.

The dual-plane method led to a statistically significant increase in the intercanthal distance between the medial canthi postoperatively. Improvements were noted in the exposure of the lacrimal caruncle and the appearance of the medial eyelid scar, and patients were overall satisfied with their outcomes. During an average follow-up of 10.8 months, three cases required secondary enlargement due to asymmetry.

The dual-plane method offers a promising solution for patients seeking correction of complications from previous medial canthoplasty, emphasizing the importance of muscle reconstruction alongside skin redraping for optimal aesthetic and functional outcomes.

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