Overview

The way someone looks, which reflects personality, emotions, and individual appeal, continues to be an important aspect of facial expression. However, certain anatomical features, such as the epicanthic fold, may interfere with the attractiveness and harmony of the image. Epicanthoplasty, a popular cosmetic surgical procedure, can address this imperfection and improve one's appearance. In this blog, you will get to know more about epicanthoplasty, including its benefits and potential complications, as well as who it is appropriate for.

What is Epicanthoplasty?

Epicanthoplasty, also known as Mongolian fold correction or Inner corner fold removal is a cosmetic surgery treatment that removes the 'Mongolian fold' that covers the medial corner of the eye. A pronounced fold may hide a large portion of the inner eye, making the eyes appear overly widely separated or too short horizontally. Some individuals might complain about having crossed eyes.

Epicanthoplasty can increase the width of the horizontal eyelid opening, resulting in larger and more alert-looking eyes.

The upper eyelid crease is absent in about 80% of Koreans and Chinese, however only 30% of Japanese and South Asians (Thailand, Cambodia, Vietnam, and so on). When it is present, it is usually excessively low (2-4 mm from the ciliary border rather than 5-8 mm). This is due to three factors distinctive to the anatomy of the Asian eyelid: there is less connection between the aponeurosis of the levator eyelid muscle and the skin, the position of the septum is often lower in Asians, and there is more fat under the septum, even in young patients, resulting in a rounded appearance of the eyelid. Approximately seventy percent of Asians are born with epicanthus, which covers the innermost part of the eye, giving it a hard and severe appearance and closing the eye. It can be corrected after surgery.

The excess skin becomes attached to connective tissue, which is then connected to the underlying muscle in the lower eyelid. A thick epicanthal fold interferes with the normal formation of a typical out-fold crease. Epicanthoplasty is often carried out combined with a double eyelid procedure to remove some of the epicanthal fold, allowing a crease to grow naturally and without strain or scarring.

The almond shape of Asian eyes contributes to their beauty. The epicanthal fold gives rise to the almond shape. Thus, removing the entire fold will result in a patient losing their Asian appearance. For the aforementioned reason, the almond form is created by eliminating the majority of the epicanthal fold while keeping a small part.

What is a Mongolian Fold?

A Mongolian crease covers the medial area of the eyes, making them look narrower than the other parts of the face. A candidate's outcome for a Mongolian fold may be less successful or natural if a simple double eyelid surgery is carried out without an epicantoplasty. When paired with epicantoplasty, eyelid surgery might result in an even length between the eyes and a more delicate, defined appearance. In the case of Asian patients, the surgeon must take care not to remove the complete epicanthal fold. In this instance, the patient may lose his or her original Asian identity.

Some of the epicanthal fold might be eliminated in Asians with a rougher appearance, leaving only a minor section. This will result in a more open, softer appearance. Patients with rounder facial features, on the other hand, should have a modest epicanthal fold created after surgery to contrast sharper eyes with other softer characteristics of the face.

The Mongolian fold is the skin on the upper part of the eyelid that covers the inner corners of the eye. Epicanthoplasty is a common procedure to treat sagging skin around the innermost parts of the eyes due to the following reasons:

- It creates eye discomfort because it distances the two eyes excessively.

- The eyes appear smaller compared to what they actually are.

- Creases cause the eyes to appear undefined.

In a nutshell, this skin fold might alter the appearance of the eyelid by making the eye look smaller sideways and more exhausted.

Although the epicanthal fold or Mongolian fold might be coupled with less pronounced upper eyelid folds, also known as "single eyelids," they are not similar. An individual might have either an upper eyelid fold and an epicanthal crease, only one of them, or neither.

Epicantoplasty is more than simply cosmetic surgery; it is requested by men and women who have unusually large folds that affect not only the appearance but also the physiological functioning of the eyes, making them appear larger.

Who is the Ideal Candidate for Epicanthoplasty Procedure?

Epicanthoplasty is the best procedure for men and women who:

- Are in relatively good health.

- Have eyes that are unusually far apart, resulting in a disproportionate appearance.

- Want to enhance their general appearance while retaining their ethnic features.

- Have undergone or are planning to have double eyelid surgery to further enhance their appearance and achieve an overall clearer and more stunning look.

- Have relatively short horizontal eye lengths.

- Prefer a delicate eye shape.

- Want to make their eyes appear bigger.

- Due to the Mongolian folds, the eyes are indistinct and appear to be quite close together.

The patient must be in good overall health to be considered an appropriate candidate for epicantoplasty. If the patient regularly smokes, he/she must cease three weeks before surgery and for three weeks afterward. This is because tobacco reduces the capacity of the body to properly recuperate.

Epicantoplasty is most commonly sought by persons who desire to appear brighter, larger, and more awake.

During the consultation 

The doctor will take a thorough history and examine the patient’s eyelids to better understand the patient’s case. He/she thoroughly investigates the patient’s request and advises on whether surgery can accomplish the desired results.

It is critical that the patient bring all of his/her prescriptions and notify the doctor if he/she is taking blood thinner medications. Measurements and photos will be gathered to help plan the surgery. During the consultation appointment, the medical team will go over the patient’s medical history and the surgical procedure in detail.

Potential Complications of Epicanthoplasty

First and foremost, if performed by a board-certified and skilled surgeon, epicanthoplasty is considered a perfectly safe procedure that has high satisfaction and success rates.

However, like with every procedure, potential risks and difficulties might arise. As a surgical candidate, you ought to take into account and be completely informed of these risks:

- Allergies: skin testing is always done before surgery to avoid any risks; nonetheless, some individuals might be allergic to the anesthesia and sutures.

- Poor healing: some patients might notice a scar for a few months following the treatment, but it will fade over time. However, to reduce apparent scars, epicantoplasty is being performed utilizing specific techniques with hidden incisions.

- Infections: while this is an incredibly rare complication caused by an infection at the incision site, it can be treated easily with a topical or oral antibiotic.

- Unsatisfactory Results: you can simply avoid this by choosing a very experienced surgeon.

Epicanthoplasty has extremely few postoperative consequences; nonetheless, the procedure itself might be problematic since the epicanthal folds cover the tear canaliculi, or tear drainage channels. This is a highly noticeable region, and the tissue between the nose and eyes is easily affected.

Any minor error can disrupt the eye's tear drainage system, but this is also readily avoided.

FAQ of Epicanthoplasty

Does an epicanthoplasty leave scars?

The surgeon will do his/her best to minimize scarring in your eyes by making only the necessary incisions. Scarring is common, however, it fades quickly within six months after the procedure.

Can I get my eye ptosis condition corrected after getting an epicanthoplasty?

Ptosis is a condition characterized by the weakness of the muscle that keeps the upper eyelid open (levator muscle). As a result, the eyelid may appear to droop. Ptosis can be corrected using one of multiple techniques to tighten up and elevate this muscle. Epicanthoplasty cannot be one of those techniques.

How much does an epicanthoplasty surgery cost?

The cost of epicanthoplasty surgery differs depending on the recommendations of the surgeon during online/in-person consultation. Epicanthoplasty is frequently performed in conjunction with other procedures, therefore the cost is commonly combined with double Eyelid Surgery or Upper Blepharoplasty. A price breakdown will be included with a specific surgery plan.

What are epicanthic folds?

Epicanthic folds are frequent among Oriental Asians and are additionally referred to as Mongolian folds. These are the skin and muscular folds that line the innermost parts of the eyes. If severe enough these folds reduce the overall dimension of the eyes, giving them a harsh and serious-like appearance. These folds can also cause a person to appear "cross-eyed".

When should I get back to my routines after epicanthoplasty surgery?

While slight exercise is acceptable after surgery, it is advisable to avoid strenuous activities, sports, or heavy lifting for at least two weeks until the wound heals.

Swimming ought to be postponed until the incision is healed and the stitches removed.

If you consider taking a shower, please keep the surgical site dry till all the stitches are removed. It is recommended to keep the wound dry while it heals.

Please avoid applying make-up near the incision or stitches.

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Epicanthoplasty is a procedure that requires creating extremely small incisions in the innermost parts of the eyes to address the aforementioned issues. As a result, the eyes are larger and brighter. If you consider having a brighter and bigger eyes, epicanthoplasty is your choice.