title: Epicanthoplasty with Epicanthal Dermatic Tension-Releasing Incision Based on Skin Projection of Inner Canthal Ligament.
abstract: BACKGROUND
  Epicanthoplasty is a reconstructive procedure that eliminates the deformity of the epicanthal fold and provides a more esthetic inner canthus. The epicanthal tension-releasing incision is a core technique of epicanthoplasty. However, which epicanthal dermatic tension-releasing incision most effectively provides epicanthal tension release remains unclear. We designed a novel dermatic tension-releasing incision based on the skin projection of the inner canthal ligament and compared it with the more conventional incision parallel to the lower inner canthal mucocutaneous junction (white line).
  
  
  METHODS
  From December 2014 to March 2016, 30 patients were divided into two groups according to the type of dermatic tension-releasing incision. Each group comprised 15 patients and 30 eyes. In Group A, incision line a was performed (tension-releasing incision parallel to the lower inner canthal mucocutaneous junction, 4-5 mm away from the mucocutaneous junction). In Group B, incision line b was performed (tension-releasing incision pointed toward the lacrimal lake, along the skin projection of the inner canthal ligament). The defect angles of the two groups were photographed intraoperatively after tension release and analyzed postoperatively.
  
  
  RESULTS
  The defect angles in Group B were significantly larger than group A (P < 0.0001). All patients obtained an esthetically pleasing inner canthus without hypertrophic scarring or injury to the lacrimal apparatus during the 3- to 24-month follow-up period.
  
  
  CONCLUSIONS
  An epicanthal dermatic tension-releasing incision based on the skin projection of the inner canthal ligament is more effective and safer than an incision parallel to the lower inner canthal mucocutaneous junction.
  
  
  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 www.springer.com/00266 .
authors.affiliation: Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China. ageorgea@163.com.
authors.forename: Linghuan
authors.initials: L
authors.lastname: Zeng
authors.affiliation: Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Cen
authors.affiliation: Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Lei
mesh_terms: D000293:Adolescent; D000328:Adult; D019882:Blepharoplasty / Q000379:methods*; D002681:China; D002921:Cicatrix / Q000517:prevention & control; D015331:Cohort Studies; D004954:Esthetics; D005143:Eyelids / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000601:surgery*; D008022:Ligaments / Q000601:surgery; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000637:transplantation*; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
keywords: Blepharoplasty; Dermatic tension-releasing incision; Epicanthal fold; Epicanthoplasty