Medial Epicanthoplasty Using a Modified Skin Redraping Method

The epicanthal fold is a skin fold over the lacrimal lake resulting from the certain anatomical structures including orbicularis oculi muscle, medial palpebral tendon and adjacent structures in the medial canthal area [1,2]. This fold is the medial extension of the upper eyelid skin and covers a portion of the lacrimal lake. The eyes with epicanthal fold are usually unattractive aesthetically and cause some restrictions when performing double eyelidplasty and other ancillary procedures [3]. It has been investigated that the incidence of epicanthal fold is 50-90% in Korean and Japanese populations [4]. Medial canthal area exhibits distinctive anatomic variations according to the presence or absence of the folds, and classified into four types (Table 1) [5]. Although an epicanthal fold is not a pathologic condition, numerous procedures have been introduced to correct this structure. Prominent epicanthal folds can be worsened when performing double eyelidplasty only without medial epicanthoplasty, because double eyelidplasty causes more tension on the epicanthal fold and results in an unpleasant round medial canthus [6]. Surgical techniques to improve epicanthal fold are mostly based on the concept of local flaps, besides they were developed and transformed to overcome drawbacks of previously conducted procedures. These techHong Lim Choi, Myung Chul Lee, Young Seok Kim, Dae Hyun Lew