Combined epicanthoplasty and blepharoptosis correction in Asian patients.
BACKGROUND
In ptosis surgery, not addressing the epicanthal fold leaves a persistent rounded nasal scleral triangle, which blunts the effect of ptosis repair and leads to patient dissatisfaction. To achieve satisfactory results, epicanthoplasty is usually performed with ptosis correction. Furthermore, surgeons usually choose epicanthoplasty methods based on personal preference, and no guideline exists for selecting optimal methods. The aim of this study was to demonstrate the usefulness of a concomitant procedure (ptosis correction and epicanthoplasty) and to provide recommendations for the selection of epicanthoplasty.


METHODS
The medical records of 99 patients that underwent simultaneous ptosis correction and epicanthoplasty from September of 2003 to January of 2011 were reviewed. Differences between preoperative and postoperative interepicanthal distances were analyzed by using patient photographs, and interepicanthal distance changes were evaluated for each epicanthoplasty.


RESULTS
Epicanthoplasty was performed in the 99 patients using elliptical excision epicanthoplasty in 24 cases, periciliary epicanthoplasty in 12 cases, half-Z epicanthoplasty in eight cases, and V-W epicanthoplasty in 55 cases. Some changes in interepicanthal distances were observed after epicanthoplasty. Interepicanthal distance changes depended on the method used (elliptical excision epicanthoplasty, 3.1 mm; half-Z epicanthoplasty, 4 mm; periciliary epicanthoplasty, 5.3 mm; and V-W epicanthoplasty, 5.4 mm). The greatest differences between preoperative and postoperative interepicanthal distance values were found for periciliary and V-W epicanthoplasty, and these differences were statistically significant. No revision operations were conducted, and most patients were satisfied with results.


CONCLUSIONS
In general, concurrent ptosis and epicanthus should be corrected to provide optimal cosmetic benefit. Periciliary or V-W epicanthoplasty is indicated when epicanthal folds are severe.


METHODS
Therapeutic, IV.
Daegu and Ulsan, Republic of Korea From the Department of Plastic and Reconstructive Surgery, College of Medicine, Catholic University of Daegu; and the Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital.
Dae Hwan
DH
Park
Sang Uk
SU
Park
So Young
SY
Ji
Bong Su
BS
Baik
D000328:Adult; D044466:Asian People; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000208:ethnology / Q000601:surgery*; D019465:Craniofacial Abnormalities / Q000208:ethnology / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D016896:Treatment Outcome; D055815:Young Adult