Double Eyelid Surgery at Duhan Plastic Surgery - Mongolian Fold Removal, Mongolian Fold Reconstruction

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What is Mongolian fold removal surgery?

If the space between both eyes looks wide,

there are many cases where skin excessively covers the inner canthus of the eye,

and the skin covering the eyeball on the inner side of the eye is called the Mongolian fold.

By removing the skin at the inner canthus,

this surgery makes the distance between the eyes normal

and opens up the inner side of the eye, which can look cramped.

Director Shin Duhan Examples of eyes with a Mongolian fold Eyes with a Mongolian fold usually have an inner eye corner that is not sharp, looks rounded, or has a steep downward angle.

A Mongolian fold is diagnosed when the distance between the eyes is 40 mm or more, or when the skin on the inner side of the eyes covers the white part of the eye, creating a cramped feeling.

What are the principles of Mongolian fold removal surgery?

♬ There should be no scar left.

The incision line should be hidden inside the eyelid boundary so that scar formation is almost nonexistent.

♩ The shape should look natural.

The inner shape of the eye should be designed horizontally so that the inner canthoplasty looks natural.

♪ It should not recur.

The inner corner should be sutured and fixed to the ligament so that it does not return to its original position.

Why does our clinic’s Mongolian fold removal surgery not leave scars?

A Mongolian fold surgery also requires an incision, so scarring is an unavoidable issue.

If the skin is incised, a scar will inevitably form.

A Mongolian fold surgery also requires an incision, so scarring is an unavoidable issue.

If the surgery is performed in a way that exposes the scar externally, the scar can look unsightly no matter how precisely it is sutured.

However, if the scar line is buried at the edge of the eye corner and hidden, the scar will be barely noticeable.

In other words, because the scar is not exposed externally, it becomes invisible.

What are the indications for Mongolian fold removal surgery?

1. When the eyes look far apart, surgery is generally performed when the distance between the inner canthi exceeds 40 mm.

The normal distance between the eyes is about 36 to 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, making the eyes look close-set.

2. When someone wants an outfold double eyelid, the presence of a Mongolian fold tends to create an infold double eyelid, so Mongolian fold removal surgery is needed to make an outfold double eyelid.

Comparison between exposed scars from Mongolian fold removal surgery and our clinic’s inner canthoplasty surgery The principles of Mongolian fold removal surgery (inner canthoplasty) are that it should leave minimal scars, have a low recurrence rate, and be a method that can be combined with double eyelid surgery.

Our clinic mainly performs surgery using the Furukwa, Y-V method.

Its advantages are that scars are less visible, the result looks natural, and when combined with double eyelid surgery, it can be performed naturally as an extension of the double eyelid line.

What are the various Mongolian fold surgery methods and the appearance of scars?

Many methods have been developed and used, but only a few are actually used in practice.

The principles of Mongolian fold removal surgery are that it should leave minimal scars, have a low recurrence rate, and be a method that can be applied together with double eyelid surgery.

Our clinic mainly uses the Furukwa method shown at the lower right.

The advantages of the surgery are that the scars are barely visible, the shape looks natural, and when combined with double eyelid surgery, the Mongolian fold surgery can naturally continue the double eyelid line.

What is the surgical process for Mongolian fold removal surgery?

Steps 1 to 3: Pull the skin toward the nose -> design the planned incision line -> administer local anesthesia.

① Pull the skin toward the nose to make it taut.
② While the skin is pulled, the design is marked with special ink. The shape of the design changes depending on the surgical method, so it is not a fixed shape.
③ Under sedation anesthesia, local anesthesia is administered to the designed area.

Steps 4 to 6: Make an incision along the planned line -> lift the skin and separate it from the muscle -> reposition the lifted skin.

④ Using a scalpel, make a precise incision along the design line.
⑤ Lift the skin away from the muscle.
⑥ Reposition the skin tissue so that the Mongolian fold is pulled toward the nose. At this time, an appropriate amount of excess skin tissue is removed.

Step 7: Suture the skin.

| 7. The skin is sutured with fine thread. A bandage does not need to be applied separately right after surgery, and the stitches are removed after 5 to 6 days. |

Examples of Mongolian fold removal surgery

What should be managed after Mongolian fold removal surgery?

1. After surgery, return the next day to disinfect the surgical area and observe the progress.

2. Remove the stitches on the 5th day after surgery.

3. Postoperative swelling is minimal, and the complete settling period is about 1 to 3 months. During this period, do not rub the surgical area vigorously.

4. For about 3 months, the inner edge of the eye may appear slightly scarred, 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 surgical area is rubbed hard, the scar may become messy or widen, so caution is needed.

What are the precautions for Mongolian fold removal surgery?

① It should only be performed when it suits your own eye shape.

During consultation, you should carefully discuss with the specialist whether Mongolian fold removal surgery is truly necessary before deciding on surgery.

② No matter which method is used, it is difficult to perform Mongolian fold removal surgery without leaving any scars at all.

It is better to perform the surgery in a way that leaves minimal scars, and it is desirable to do it by hiding the scar inside.

Because the scar is not visible externally, there is almost no sign that surgery was performed.

When should Mongolian fold removal surgery not be performed?

① If the distance between the eyes is not 40 mm, the normal distance is usually about 36 to 37 mm.

If it is less than 40 mm, Mongolian fold removal surgery should not be performed.

If inner canthoplasty is done on eyes with a normal distance, the side effect of the eyes looking too close-set may occur, so caution is needed.

② If the distance between the eyes is wide but the inner eye corners are already sharp in shape, Mongolian fold removal surgery should not be performed.

The goal of removing a Mongolian fold is to open up and soften the inner part of the eye when the inner eye shape is round, but if the inner eye area is already sharply opened, surgery may make the eyes look even more severe, so caution is needed.

What is Mongolian fold reconstruction?

It refers to surgery that restores the original eye shape after unnecessarily performing inner canthoplasty even though it was not indicated,

which instead made the expression look worse.

Why is Mongolian fold reconstruction needed?

If inner canthoplasty was done because it seemed necessary, whether restoration is needed again is something that must be considered.

It happens when inner canthoplasty is recommended unconditionally without considering the postoperative eye shape.

If inner canthoplasty is performed without a proper indication, various problems can arise, so please keep this in mind.

What problems occur after unnecessary Mongolian fold removal?

1. The distance between the eyes becomes shorter than normal, making the eyes look close-set.

2. If inner canthoplasty is done when the inner eye corner is already sharp, the eye shape becomes sharper and the eyes look more severe.

3. The mucosa on the inner side of the eye becomes excessively exposed and looks unpleasant.

4. After inner canthoplasty, the inner line becomes thicker, and in cases where an infold line is desired, an unwanted outfold line results.

5. After revision double eyelid surgery to reduce the inner line, if it is done together with inner canthoplasty, the double eyelid line may not become smaller or may even become larger.

How is Mongolian fold reconstruction performed?

Since restoration surgery leaves more scars than inner canthoplasty, this must be taken into account during surgery.

The reconstruction is performed using a V-Y advancement flap method or a Z-plasty method, designed in the opposite direction of inner canthoplasty.

The method used differs depending on the shape of the individual’s eye and the amount of available tissue.

Examples of Mongolian fold reconstruction surgery Before performing inner canthoplasty restoration, it is important not to create a situation where restoration becomes necessary in the first place.

Making the expression worse through inner canthoplasty and then undergoing restoration surgery to reverse it is a waste of both money and time. ㅠㅠ

You should carefully judge and decide whether the surgery is truly necessary for you.

What is our clinic’s Mongolian fold reconstruction method?

Based on more than 20 years of extensive clinical experience and know-how in eye plastic surgery, our clinic handles cases where the inner canthoplasty has been done too extensively and restoration is desired.

If the current double eyelid is natural and there is enough excess skin at the front, the procedure may be possible in one session, but if there is not enough excess skin and the double eyelid is awkward and large, staged reconstructive plastic surgery may be needed.

In general, if the thickness (width) of the double eyelid is around 6 mm or larger, or if the fixation point of the double eyelid is very high, it may take a long time for it to become natural.

Reconstruction can be performed to match your own eye shape.

It takes about 1 to 3 months for the swelling to go down and for the area to settle.

Even after reconstruction surgery, it cannot be exactly the same as the old eyes, and because the skin around the eyes must be gathered toward the eye area during reconstruction, care must be taken to prevent the scar from widening below the inner eye.

Scars do not form because the inside of the skin is sutured.

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