A Modified Z-Epicanthoplasty Combined With Double Eyelidplasty

Objective:To explore the new procedure combining epicanthus correction by modified Z-plasty with blepharoplasty, the Asian eyelid characteristics were analyzed and aesthetic appearance results were evaluated.Methods:From2010to2013, the authors performed epicanthoplasties using the modified Z-plasty and double eyelidplasty for191Chinese patients. Discrepant Z-shape incision were made on the medial canthus. Release and partially cut off the musculus orbicularis oculi as well as trip the superficial fibrous connective tissue of the medial canthal ligament with simultaneous blepharoplasty. ICD were measured before and3months after the operation. Aesthetic appearance results and medial canthal scar development were analyzed.Results:The technique showed good results in most cases with no recurrences of epicanthus and complications. The ICD reduction ranged from8.3%to19.13%(average14.47%). There were no conspicuous scars in the medial canthus with satisfied aesthetic appearance.162cases were given more than3-months long follow-ups with great satisfaction from152patients.8cases expressed their discontent due to asymmetry of the eyelid appearance. Blepharoplasties were repeated in2cases6months after the operation resulting from the double eyelid disappearance and they obtained good results.Conclusion:Tripping the medial canthal subcutaneous tissue, musculus orbicularis oculi and the superficial fibrous connective tissue of medial canthal ligament layer by layer is the key point of our procedure. The easy design and operation, and the excellent results demonstrate that it is a good opotion for both the plastic surgeons and the Asian patients.