A Novel U-Flap Epicanthoplasty for Asian Patients.
BACKGROUND
The epicanthal fold is a distinct characteristic of the Asian upper eyelid, which may impair the beauty of the eyes and the outcome of double eyelid blepharoplasty. Although many surgical procedures have been reported, their main drawbacks include a conspicuous scar in the medial canthal area and an unnatural palpebral contour. We devised a novel surgical approach to correct the epicanthal fold with acceptable scarring.


METHODS
From June 2011 to October 2014, U-flap epicanthoplasty was performed on 118 Chinese patients in our department. The U-flap was designed on the medial canthal skin. After complete dissection of the flap from the dislocated orbicularis muscle and underlying connective tissue, the flap naturally rotated upward to a line consistent with the direction of the palpebral fold. The flap was then subcutaneously fixed to the medial part of the medial canthal ligament. Finally, the redundant skin was trimmed off and the incision was sutured without tension. Patients were evaluated before and 12 months after surgery.


RESULTS
The average decrease in the intercanthal distance was 4.36 ± 0.32 mm. The general satisfaction rate was 97.5 %. Three patients showed bilateral hypertrophic scar formation on both bilateral medial canthal incisions and palpebral incisions; however, the scarring subsided after three triamcinolone acetonide injections. No epicanthal fold recurrence or other complications were observed during the 12-month follow-up period.


CONCLUSIONS
U-flap epicanthoplasty is a simple and effective method for elimination of types I-III epicanthal folds. However, its long-term effects require further study.


METHODS
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Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
Tao
T
Zan
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
Rui
R
Jin
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
Haizhou
H
Li
Department of General, Trauma, Hand, and Plastic Surgery, University of Munich, Munich, Germany.
Tanja
T
Herrler
Department of Plastic and Aesthetic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
Xuchang
X
Meng
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
Xiaolu
X
Huang
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
Qingfeng
Q
Li
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China. gubinabc@sina.com.
Bin
B
Gu
D044466:Asian People; D019882:Blepharoplasty / Q000379:methods*; D015331:Cohort Studies; D004954:Esthetics; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome
Blepharoplasty; Double eyelid plasty; Epicanthal fold; Epicanthoplasty; Epicanthus