title: Two-Z-epicanthoplasty in a three-dimensional model of Asian eyelids.
abstract: BACKGROUND
  Epicanthoplasty is a procedure currently available for medial epicanthus correction. However, potential problems such as difficult designs, undercorrection, and unpleasant scarring in the medial canthus area make patients hesitant about undergoing epicanthoplasty. These barriers are challenges to surgeons.
  
  
  METHODS
  From January 2007 to May 2010, epicanthoplasty was performed for 23 patients using two-Z-plasty in a three-dimensional surgery model. A total of 20 patients underwent a simultaneous double-eyelid operation when required. The medial canthal distance was measured preoperatively and 12 months postoperatively. The extent of postoperative scarring and improvement of the epicanthal fold were evaluated after surgery.
  
  
  RESULTS
  The average intercanthal length decreased significantly from a mean of 37.0±2.1 mm preoperatively to 31.4±1.9 mm 12 months postoperatively (p<0.01, paired t test). Epicanthoplasty yielded excellent aesthetic results in terms of an open medial canthus without definite relapse, hypertrophic scarring, and injury of the lacrimal apparatus during the 12-month follow-up period.
  
  
  CONCLUSIONS
  Two-Z-epicanthoplasty can be reproduced easily in a three-dimensional surgery model. This procedure is very effective for correction of the epicanthal fold, resulting in a pleasant-appearing, inconspicuous scar and a long-lasting outcome.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
authors.affiliation: Departments of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No.639 Zhizaoju Road, Shanghai, China.
authors.forename: XiaoJie
authors.initials: X
authors.lastname: Hu
authors.forename: XiaoXi
authors.initials: X
authors.lastname: Lin
authors.forename: Gang
authors.initials: G
authors.lastname: Ma
authors.forename: YunBo
authors.initials: Y
authors.lastname: Jin
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Chen
authors.forename: Xiaoxiao
authors.initials: X
authors.lastname: Ye
authors.forename: Yajin
authors.initials: Y
authors.lastname: Qiu
mesh_terms: D000328:Adult; D044466:Asian People; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000601:surgery; D002681:China; D002921:Cicatrix / Q000517:prevention & control; D005143:Eyelids / Q000033:anatomy & histology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008953:Models, Anatomic; D017060:Patient Satisfaction; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult