Helping Revision Epicanthoplasty Settle Naturally

The eyes can appear different in size

depending on the vertical width between

the upper and lower eyelids.

When it comes to the overall impression,

the length from side to side

affects how they look.

If the eyes are short in length but

only tall in height, they may also

look unnatural. Conversely, when

the length is greater than the height,

they can give the impression of

squinting, which may lead to concerns

of its own.

Because the appearance of the eyes

is influenced by several factors that

must be considered together in line

with each person’s natural shape,

various methods, such as epicanthoplasty

and lateral canthoplasty, may be used

together when creating a new double-eyelid

crease or reworking an existing line

in order to make the eyes appear

larger and more open.

Although this is a widely used method,

if it was performed in a way that did

not suit the individual, revision

epicanthoplasty can be considered to

close the area again and reopen it

in a new position.

In particular, the reason many East

Asians have a constricted inner corner

of the eye is the presence of the

Mongolian fold. When the hook-shaped

area is opened to an appropriate degree,

the previously closed-looking eyes can

appear more open, and the horizontal

width of the eyes can also become

wider than before. For this reason,

it is often performed together with

double-eyelid surgery.

As a result, more people are looking

into and considering revision

epicanthoplasty. Even a slight

difference in the width created during

the incision can lead to both aesthetic

and functional problems.

It may also be performed to address

problems such as redness of the eye

caused by the lacrimal lake becoming

exposed outside the skin. However,

if a firm, pale scar remains after

the incision, the area may be excised

again and sutured in stages to remove

it.

Because delicate technique is required,

revision epicanthoplasty may also be

considered when the shape settles

differently from what was expected

after the first procedure. If excessive

incision has made too much of the

inner corner visible, creating a sharp

appearance, or if the area was closed

in a stuffy, square shape that does

not meet aesthetic expectations,

it is necessary to make a careful

decision while considering the method

of treatment and the recovery period.

Since even a slight difference can

change the appearance of the eyes,

it is important to check in advance

whether a meticulous micro-incision

method, approaching the procedure

down to 0.01 mm, is used and whether

the surgeon has sufficient clinical

experience with both epicanthoplasty

and revision procedures.

Because this is more difficult than

creating a double-eyelid crease and

has a greater effect on the eventual

result, you should also confirm whether

the procedure is performed precisely

to reduce errors, how much the risk

of future scarring can be reduced by

anticipating its development, and what

support is provided during recovery.

The reason it is particularly important

to anticipate the outcome and proceed

carefully is that reconstruction is the

primary purpose of the procedure.

Even if it is not visible on the surface,

there may already be signs of tissue

damage left from the first procedure,

or the tissue may still be weakened

because it has not fully recovered.

If the area is treated before it has

healed properly, a depressed scar may

appear, so caution is required.

When reconstructing an incorrect result,

it is important to proceed slowly and

in stages, while also considering how

the appearance can be improved later.

A double-flap technique is used to

correct both the shape and function.

The double-flap reconstruction method

used to help the area settle into a

new position begins by checking whether

there is any damaged internal tissue

before revision epicanthoplasty.

A precise examination is performed

first because the existing skin tissue

must be usable both above and below

the area. This makes it possible to

partially close an excessively opened

eye shape and then reopen it again

to correct the aesthetic appearance

as well.

Because the eyes move frequently,

there is a possibility of deformation

during recovery. The incision is

therefore planned from the beginning

so that the scar can heal as naturally

as possible throughout the healing

process.

This requires particular caution because

this is a technically challenging area,

making it relatively difficult to achieve

a proper improvement without precise

incisions and suturing.

If the inner corner was opened sharply

forward, exposing the lacrimal lake

and making it appear red, the area may

be closed using the remaining skin

tissue. However, if it closes in an

unnatural shape, new problems can

arise, such as the eyes appearing

farther apart and more constricted.

It is therefore important to overcome

these issues with a surgeon who has

expertise in precise incisions and

suturing.

If the Mongolian fold was originally

pronounced, strong pulling forces may

continue to act internally even after

reconstruction, and a strongly

hook-shaped fold may form again at

the inner corner.

For this reason, revision epicanthoplasty

requires more than simply focusing

on suturing the outer skin. Internal

muscle adhesions must also be assessed

carefully to reduce problems that may

arise during recovery.

The procedure should be planned in

detail to prevent sharp Mongolian folds

from forming again due to adhesions

during healing, while creating an inner

corner shape that suits each individual

at an appropriate degree.

At this stage, every factor affecting

the appearance of the eyes should be

considered, including the precise width,

the length appropriate for the height,

and symmetry.

Reconstruction should account not only

for the damage that occurred previously,

but also for measures to address scars

that have already formed.

Because the various aspects must be

assessed and treated delicately, it is

appropriate to proceed carefully after

hearing the opinion of a physician with

extensive clinical experience in this

field.

Although internal and external damage

and discomfort are addressed together,

this is still a revision procedure.

To avoid discomfort or anxiety during

future recovery, it is important to

undergo a detailed examination in

advance, explain the difficulties you

have experienced and what you want,

and discuss them thoroughly.

Solid facilities and equipment are of

course also necessary. However, since

the outcome of revision epicanthoplasty

can vary significantly depending on

the surgeon’s meticulous technical

differences, it may be helpful to check

whether the clinic has a resident surgeon

with extensive experience handling

difficult cases.

In particular, procedures requiring

incisions can significantly affect future

results depending on how properly the

recovery process is managed. You should

therefore also look carefully into whether

a systematic care program is in place.

Previous image Next image