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Duhan Plastic Surgery Clinic · 두한성형외과 DUHANISM · September 10, 2019
Mongolian fold # Mongolian fold removal # non-incisional epicanthoplasty # upper canthoplasty # epicanthoplasty effect # Mongolian fold surgery # canthoplasty # repositioned cantho...
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This page is an English translation of a Korean Naver Blog archive entry. For exact wording and source context, verify against the Korean archive original and the original Naver post.
Clinic: Duhan Plastic Surgery Clinic
Original post date: September 10, 2019
Translated at: April 25, 2026 at 8:22 AM
Medical note: This translation does not guarantee medical accuracy or suitability for treatment decisions.
When the distance between the two eyes appears wide,
the skin at the inner canthus often covers too much of the eyeball,
and the skin covering the eyeball on the inner side of the eye is called the Mongolian fold.
Mongolian fold removal (epicanthoplasty) is a procedure that removes the skin of the inner canthus
to make the distance between the eyes look normal and open up the inner corner of eyes that appear narrow.
A Mongolian fold (inner canthal epicanthal fold) is diagnosed when the distance between the eyes is 40 mm or more,
or when the inner-eye skin covers the white part of the eye, creating a feeling of heaviness.
Eyes with a Mongolian fold usually have an inner corner that is not sharp,
and are often rounded or have a steep downward angle.
Principles of Mongolian fold removal
| Scarring should not remain. The incision line should be hidden inside the boundary line of the eyelid so that scarring is kept to a minimum. |
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| The shape should look natural. The inner corner of the eye should be designed horizontally so that the epicanthoplasty looks natural. |
| It should not recur. The inner corner should be fixed and sutured to the ligament so that it does not return to its original position. |
At our clinic's Mongolian fold removal (epicanthoplasty),
why scars do not occur
If the skin is incised, scars will inevitably occur.
The same is true for the Mongolian fold, since surgery is performed by making an incision, so scarring is unavoidable.
If the surgery is performed in a way that exposes the scar externally,
the scar may look unattractive no matter how carefully it is sutured.
However, if the scar line is buried at the very edge of the outer corner of the eye so that it is hidden,
the scar will be barely noticeable.
In other words, because the scar is not exposed externally, it is not visible.
Indications for Mongolian fold removal (epicanthoplasty)
| 1. When the eyes appear far apart. As a rule, surgery is performed when the distance between the inner canthi exceeds 40 mm. The normal distance between the eyes is about 36–37 mm, but if the distance is normal and there is still a Mongolian fold, it is better not to perform surgery. If done incorrectly, the distance between the eyes can become too short and make the eyes look too close together. |
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| 2. When you want to create out-fold double eyelids. If a Mongolian fold is present, an in-fold double eyelid is formed, so Mongolian fold removal is necessary to create out-fold double eyelids. |
Exposed Mongolian fold removal (epicanthoplasty)
Comparison of scars and our clinic's epicanthoplasty surgery
The principles of Mongolian fold removal (epicanthoplasty) are
that scarring should be minimal,
recurrence should be low,
and it should be a method that can be performed together with double eyelid surgery.
At our clinic, we mainly perform surgery using the Furukwa and Y-V methods.
The advantages are that scars are less visible,
it looks natural,
and when performed together with double eyelid surgery, it has the advantage of naturally extending the double eyelid line.
Various Mongolian fold removal (epicanthoplasty)
methods and the appearance of scars
Various methods have been developed and used, but only a few are actually in use.
The principles of Mongolian fold removal (epicanthoplasty) are that scarring should be minimal,
recurrence should be low,
and it should be a method that can be performed together with double eyelid surgery.
At our clinic, we mainly perform surgery using the Furukwa method shown at the lower right.
The advantages are that scars are barely visible,
the shape looks natural,
and when performed together with double eyelids, the Mongolian fold can be removed naturally along the extension of the double eyelid line.
Mongolian fold removal (epicanthoplasty) process
Stages 1 to 3
Pull the skin toward the nose. -> Design the intended incision line. -> Apply local anesthesia.
The skin is pulled toward the nose to make it taut.
With the skin pulled, the design is drawn using special ink.
The shape of the design varies depending on the surgical method, so there is no fixed shape.
Stages 4 to 6
Make an incision along the planned incision line. -> Lift the skin and separate it from the muscle. -> Reposition the lifted skin.
A precise incision is made with a scalpel along the design line.
The skin is lifted away from the muscle.
The skin tissue is repositioned so that the Mongolian fold is pulled toward the nose.
At this point, an appropriate amount of the remaining skin tissue is removed.
Stage 7
Suture the skin.
No separate bandage needs to be applied immediately after surgery,
and the stitches are removed after 5 to 6 days.
Before-and-after photos of Mongolian fold removal (epicanthoplasty)
Aftercare following Mongolian fold removal (epicanthoplasty)
| 1. For follow-up after surgery, visit the next day to disinfect the surgical area and monitor the progress. |
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| 2. Stitches are removed on the 5th day after surgery. |
| 3. Swelling after surgery is minimal, and the time for the result to fully settle is about 1 to 3 months. During this period, the surgical area should not be rubbed aggressively. |
| 4. For about 3 months, a slight scar may be visible at the inner edge of the eye, but this is a normal process, and after 3 months it becomes barely noticeable. |
| 5. Be careful not to rub the surgical area when washing your face. If the area is rubbed hard, the scar may become messy or widen, so caution is needed. |
Precautions for Mongolian fold removal (epicanthoplasty)
| It should be performed only when it suits the shape of your eyes. During consultation, you should carefully discuss with the specialist whether Mongolian fold removal is truly necessary before deciding on surgery. |
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| With Mongolian fold removal, no matter which method is used, it is difficult to perform the surgery without leaving any scar at all. It is better to perform the surgery in a way that leaves as little scarring as possible, and it is advisable to use a method that hides the scar inside. Because the scar is not visible externally, there is almost no visible sign that surgery was performed. |
When Mongolian fold removal (epicanthoplasty) should not be performed
| If the distance between the eyes is not 40 mm, the normal distance is usually around 36–37 mm. If it is less than 40 mm, Mongolian fold removal should not be performed. If epicanthoplasty is done on eyes with a normal distance, a side effect may occur in which the eyes appear too close together, so caution is needed. |
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| If the distance between the eyes is wide but the inner corner of the eye is already sharp in shape, Mongolian fold removal should not be performed. The purpose of removing the Mongolian fold is to open up and soften the inner corner when that area is rounded, but if the eye is already sharply shaped, surgery may make the eyes look even harsher, so caution is needed. |
Frequently asked questions and answers about Mongolian fold removal (epicanthoplasty)
▶ What is a Mongolian fold?
A Mongolian fold, also called an inner canthal epicanthal fold,
is a condition in which there is excess skin at the inner corner of the eye
that covers the white part of the eye.
Usually, when a Mongolian fold is present, the eye shape looks heavy,
and the eyes appear to be set far apart.
▶ Does Mongolian fold removal leave scars?
Most Mongolian fold removal procedures leave some degree of scarring.
Although various methods have been developed for Mongolian fold removal,
only a few are actually used.
It is best to choose a method that leaves as little scarring as possible and looks natural.
Because surgical methods differ by clinic, it is better to have the procedure done using a method that leaves less scarring,
has no recurrence,
and produces natural-looking results.
▶ Are Mongolian fold removal and epicanthoplasty the same thing?
Yes, they mean the same thing.
Mongolian fold removal is also called inner canthal epicanthoplasty,
and in common terms, it is called epicanthoplasty.
They all mean the same thing.
However, lower canthoplasty is a surgery that opens the outer side of the eye,
so it is the opposite of epicanthoplasty.
▶ Can double eyelid surgery and Mongolian fold removal be done at the same time?
Or do they need to be done separately?
The two procedures can be done at the same time or separately.
You can have double eyelid surgery first and then Mongolian fold removal later,
or have Mongolian fold removal first
and double eyelid surgery at a later time.
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