Epicanthoplasty with Modified Y-V Advancement Procedure

Abstract

The presence of epicanthal folds and lack of supratarsal folds are unique features in most Asian eyelids. Although many surgical procedures are available to eliminate epicanthal folds, scarring on the medial canthus is still an obstacle for surgeons to overcome. From January of 1989 to November of 1997, we used modified Y-V advancement procedures in 148 cases to correct epicanthal folds in Asian eyelids. Five of those cases involved congenital palpebral anomalies, including congenital entropion, congenital ptosis, and Down syndrome. There were few complications in our series. We believe that the modified Y-V advancement procedure causes minimum scarring on medial canthus in correcting Oriental epicanthal folds and congenital palpebral anomalies. This procedure can also be simultaneously combined with blepharoplasties and corrective procedures of eyelids.

Medial Epicanthoplasty Using a Modified Skin Redraping Method

“…Keywords Epicanthus, Fold, Correction, Natural eyelid niques include the Mustarde four-flap [7], V-M plasty [8], V-W plasty (Uchida procedure) [9], modified V-Y flap [10], and various Z-epicanthoplasty techniques [11]. However, there are potential disadvantages with these techniques such as unnatural ciliary position of the lower eyelids, prominent scarring caused by excessive tension and limitations to obtain pretarsal fold running parallel to the upper eyelid margin.…”

“…Epicanthoplasty can create a sharp medial corner of the epicanthus and widen the palpebral fissure which allows the eyes look more open. Many epicanthoplasty methods had been introduced to correct epicanthi fold, such as elliptical excision, Z-plasty [4][5][6], W-plasty [8], horizontal Y-V advancement [2] and other modified techniques [3,10,11]. Certain methods, however, created deficiency of the skin tissue and prominent scarring in the medial canthal area, which does not contribute to the attractive appearance.…”

New Technique for Medial Canthoplasty That Incorporates Modified V-W Epicanthoplasty

“…Various epicanthoplasty designs exist, [1][2][3][4][5] and we believe that a split V-W plasty represented by the Uchida method is a simple and excellent design that produces inconspicuous scars 2,3 ; however, the disadvantage of this method is that it is difficult to reconstruct the orbitonasal angle. To mitigate this disadvantage, Park 4 used the tetrahedral effect of "Z-plasty," and we agree that the key element to create the pretarsal crease in the medial canthal area is to anchor the flap deeply.…”

“…Several epicanthoplasty methods used to avoid this problem have been described. [1][2][3][4][5] Asians have an epicanthal fold; hence, the results of the conventional methods appear to be incorrect because the orbitonasal angle and appropriate shape cannot be reconstructed. In this article, we describe our new design for epicanthoplasty.…”

“…Arch Facial Plast Surg. 2012;14 (1): [59][60][61] Telecanthus, which is the lateral displacement of the medial canthus, can be a congenital deformity or can occur after facial trauma. To correct this displacement, it is necessary to medially shift the medial canthus and attach its tendon to the bone.…”