The Causative Factors or Characteristics of the Asian Double Eyelid

Kakizaki, Hirohiko; Takahashi, Yasuhiro; Nakano, Takashi; Asamoto, Ken; Ikeda, Hiroshi; Iwaki, Masaya; Selva, Dinesh; Leibovitch, Igal

doi:10.1097/iop.0b013e31825e6a88

Cited by 32 publications

(19 citation statements)

References 15 publications

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“…7 In conclusion, our in vivo study in young healthy volunteers confirms previous published anatomical differences between single and double eyelids in cadavers. 9 The single eyelid shows slightly thicker SOOC both in the pretarsal area and at the eyelid crease but not at 5 mm above the eyelid crease level.…”

Section: Discussionmentioning

confidence: 98%

Differences Between Single and Double Eyelid Anatomy in Asians Using Ultrasound Biomicroscopy

Saonanon

Thongtong²,

Wongwuticomjon³

2016

Asia-Pacific Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 98%

Differences Between Single and Double Eyelid Anatomy in Asians Using Ultrasound Biomicroscopy

Saonanon

Thongtong²,

Wongwuticomjon³

2016

Asia-Pacific Journal of Ophthalmology

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“…Hirohiko et al and Yulan et al verified that the preseptal orbicularis muscle was the anatomical etiologic factor of the epicanthus in their anatomical examination. 11,12 Hirohiko et al found that the preseptal orbicularis fasciculi ran obliquely around the epicanthus and coincided with the direction of the epicanthus in their anatomical study. They also reasoned that the epicanthus formation depended on the intermuscular fibers of the oblique direction of the preseptal orbicularis muscle.…”

Section: Evolution Of the Epicanthus (Kwon's Theory): Etiology And Prmentioning

confidence: 92%

Reconsideration of the Epicanthus: Evolution of the Eyelid and the Devolutional Concept of Asian Blepharoplasty

Kwon

Nguyen

2015

Seminars in Plastic Surgery

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Double eyelidplasty is the most frequent cosmetic procedure for Asians; however, the epicanthus has been a conundrum that limits the cosmetic results of a double eyelidplasty. A double eyelidplasty without epicanthoplasty tends to be unattractive or unnatural. Aesthetically, the epicanthal fold is worsened when performing double eyelidplasty without epicanthoplasty because double eyelid formation aggravates the vertical tension on epicanthal skin. It has been a longstanding dilemma for plastic surgeons as to which procedure to choose: an infold-type double eyelidplasty with a less satisfactory result or an outfold-type double eyelidplasty with concomitant epicanthoplasty with the risk of a hypertrophic scar on the Asian eyelid. When the epicanthal fold is severe, the surgical incision for a skin flap also becomes longer; a scar can be easily visible in the conventional method, which is based on the concept of a local skin flap and lacks a consideration of the upper orbicularis muscle and vertical epicanthal tension.Although it has been reasoned that combined epicanthoplasty is helpful in Asian double eyelidplasty, there has not been a clear understanding of the epicanthal fold, promoting treatment controversy. Early on, many epicanthoplasty methods were developed, mostly based on the skin flap concept. Current methods include combined techniques such as skin excision, Z-plasty, myotomy or myectomy of preseptal orbicularis muscle, skin redraping, plication of medial canthal ligament, and so on.1-5 However, the development of incomplete methods has been unavoidable due to a lack of understanding of the true nature of the epicanthus. As the clinical significance of the epicanthus is mainly related to an Asian double eyelidplasty, an essential epicanthoplasty should be undertaken for all types of double eyelid surgery including the high outfold type (parallel type). But there has not yet been an effective epicanthoplasty method that provides a universal solution for an Asian double eyelidplasty. Our approach addresses the formative causes of epicanthal deformity and their relationship with the double eyelid. Keywords► eyelid evolution ► epicanthus ► epicanthoplasty ► double eyelid ► double eyelidplasty ► Asian blepharoplasty Abstract Double eyelidplasty is the most frequent cosmetic procedure for Asians; however, the epicanthal fold has been a conundrum that has limited the cosmetic results of Asian blepharoplasty. To achieve satisfactory results in an Asian double eyelidplasty, the key is an understanding of the true nature of the epicanthus. We propose that the epicanthus developed in the eyelid's evolutionary process. Selective detachment and superomedial reposition of the preseptal portion of the upper orbicularis muscle can resolve the primary cause of epicanthal formation without functional impairment. The vertical skin shortage and resultant skin tension of the upper eyelid can be corrected by subcutaneous dissection and transverse advancement of skin flap. An epicanthoplasty is part of the core surgery for A...

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“…56 Kakizaki and associates 56 performed an experimental anatomical study to address this issue and found that the thickness of orbicularis oculi muscle or the way it folds (bending shape) and the thickness of the skin at the skin crease are major causative factors in Asian double-eyelid formation. It has evolved over the years to yield consistent results.…”

Section: Blepharoplastymentioning

confidence: 99%

Recent Advances in Ophthalmic Plastic Surgery

Honavar¹,

Manjandavida²

2013

Asia-Pacific Journal of Ophthalmology

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The Causative Factors or Characteristics of the Asian Double Eyelid

Abstract: The thickness of orbicularis oculi muscle or its bending shape, and the thickness of the skin at the skin crease, are major causative factors in Asian double eyelid formation.

Cited by 32 publications

References 15 publications

Differences Between Single and Double Eyelid Anatomy in Asians Using Ultrasound Biomicroscopy

Differences Between Single and Double Eyelid Anatomy in Asians Using Ultrasound Biomicroscopy

Reconsideration of the Epicanthus: Evolution of the Eyelid and the Devolutional Concept of Asian Blepharoplasty

Recent Advances in Ophthalmic Plastic Surgery

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