The epicanthal fold is a semilunar flap of eyelid skin on the medial aspect of the eye. Many surgical techniques have been described to eliminate the epicanthal fold, which is a feature uniquely predominant among the Asian population. However, many surgeons avoid epicanthoplasty because of the fear of visible scar formation. From January of 2002 to April of 2004, 118 patients with medial epicanthal folds underwent epicanthoplasty using a periciliary Y-V advancement procedure for the prevention of visible scar formation. The mean age of the patients was 25.2 years (range, 16 years to 56 years). The median follow-up period was 6 months (range, 2 weeks to 2 years). We performed periciliary Y-V epicanthoplasty only when a patient had wide interepicanthal distance (over 32 mm) or a completely eclipsed lacrimal caruncle. Most of the patients attained satisfactory results, and there were few complications in our cases. Scarring of the medial canthal area has not been a problem with this technique because we designed incisions along the eyelashes and skin-mucosal junctions. We have found that our periciliary Y-V epicanthoplasty is a very reliable and effective method for eliminating the epicanthal fold with minimal scar formation.

Various methods using autologous bone grafts or alloplastic implants have been reported for the contouring of flat or depressed foreheads; the majority of these reports deal with correction of cranial deformities arising from injuries or congenital conditions. These methods all require relatively or quite invasive procedures. However, it is of course desirable if cosmetic surgery can be performed with minimally invasive procedures. The author presents an outpatient procedure using methyl methacrylate for aesthetic forehead contouring. From January 2006 to November 2012, 210 patients underwent methyl methacrylate forehead augmentation on an all outpatient basis. Under only local anesthesia, a V-shaped transverse scalp incision (5 cm length) was made behind the front hair line, followed by subperiosteal dissection of the skin covering the forehead. Methyl methacrylate was inserted and manually molded to the desired contour through the skin. The amount of methyl methacrylate used ranged from 10 to 40 mL, with a mean of 25 mL, depending on the size and shape. The follow-up period ranged from 3 months to 6 years, averaging 45 months, and with the exception of a very small percentage, all patients were satisfied with the results. Based on these results, the author concludes that aesthetic forehead augmentation using methyl methacrylate is an effective surgical procedure with minimal side effects and a high degree of patient satisfaction.

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We report the case of a 3-year-old girl with temporomandibular ankylosis, which was treated with a costochondral graft and required two further resections because the grafted tissue had overgrown.

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