Surgical revision of the oriental lid

In many oriental upper lids the levator aponeurosis does not insert into the skin as it does in the occidental lid. The upper lid fold is therefore absent in these oriental eyes. In addition, epicanthus tarsalis is common in the oriental, and the caruncle is often hidden. In the revision of the oriental lid any one of a number of medial canthoplasty techniques may be used in conjunction with the surgical formation of an upper lid fold. A double Z-plasty for the epicanthus revision combined with the formation of the lid fold by attaching the levator aponeurosis to the skin is technically simple and yields cosmetically acceptable results.