Monolid Epicanthic Fold Incision: Why Repositioning Is Needed Instead of Removal

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Gangnam MOOi Plastic Surgery eye surgery epicanthic fold repositioning front incision double eyelid line

“Does my eye look crowded at the inner corner? Can I just get a front incision?”

This is the question people considering an epicanthic fold front incision ask most often.

To put it simply, the key is not to remove the epicanthic fold unconditionally, but to ‘reposition’ it.

If it is cut away blindly, side effects such as exposed red tissue or a sunken scar may occur.

Today, I’ll explain what the epicanthic fold is, why it should be repositioned rather than removed, and how it relates to the double eyelid line that suits your eyes.

Why does the epicanthic fold make the eyes look crowded?

In medical terms, it is called the ‘medial epicanthal fold.’ In simple terms, it is the skin fold that covers the inner corner of the eye.

It forms because of the pulling force of the muscles and ligaments inside the skin, and it is a very natural feature found in about 70–80% of East Asians.

However, when this fold is strong, the horizontal length of the eyes can look shorter, and the space between the eyebrows can appear wider, creating an overall crowded impression. That is why people consider an epicanthic fold front incision.

The double eyelid line is actually determined by the epicanthic fold

Many people say, “Please make it a clear outer line like a celebrity’s!” But in fact, the starting point of the double eyelid line is determined by the shape of the epicanthic fold before the surgeon’s technique.

Depending on how much the epicanthic fold covers the inner corner of the eye, an inline, in-out line, or outer line is determined.

Comparing epicanthic fold/double eyelid inline/in-out/outer line eye photos at Gangnam MOOi Plastic Surgery

What happens if the epicanthic fold is severe but you force a high line?

The front part may remain covered while only the back part becomes high, creating a “sausage eye,” or the line may bend and look unnatural.

To create a beautiful double eyelid, the epicanthic fold should be examined first.

Removal vs. repositioning: what’s the difference?

The approach to epicanthic fold front incision is also completely different. Here is a quick comparison.

Category	Removal method	Repositioning method
Principle	Cut the skin away	Release the muscles and ligaments, then reorganize the skin texture
Scar	Sunken scars may occur	Incision follows the natural fold, so it is barely visible
Exposure of red tissue (medial canthal show)	May be exposed excessively	Exposed only to a natural degree
Possibility of recurrence	May recur if muscle tension remains	Less recurrence with muscle and ligament correction
Naturalness	Can look sharp	Looks naturally like your own eyes

Before-and-after photos of epicanthic fold repositioning front incision at Gangnam MOOi Plastic Surgery

Why redraping is needed

The epicanthic fold is not a lump that needs to be removed, but a normal structure of our eyes. Instead of excessively cutting away skin, this method relaxes the tension of the muscles and ligaments pulling from the inside, and gently re-spreads the skin texture so it can settle naturally.

This way, you can achieve a brighter, more open look that still looks natural, without worrying about scars or excessive exposure of red tissue.

Common concerns during consultation

In actual consultations, many people ask, “If I get a front incision, won’t the distance between my eyes become too narrow and make me look close-set?” If the distance between the eyebrows is already narrow, it is better to consider a back incision together rather than forcing a front incision.

There are also patients who come in for revision surgery saying, “I had a front incision done elsewhere, but the scar became sunken.” In most cases, the cause is the removal method where only the skin was cut away. At MOOi Plastic Surgery, we approach it with the repositioning method from the start, which helps minimize these problems.

Frequently asked questions (FAQ)

Q. Does it become attached again after a front incision? If the surgery is done properly, it does not reattach. However, if only the skin is cut, the inner muscle tension can cause it to try to return. That is why internal correction that fully releases the adhesion between the muscles and ligaments must be done together to maintain the result without recurrence.

Q. Are front incision scars noticeable? The repositioning method makes an incision and sutures along the eye’s natural internal fold pattern, so after recovery, they are barely noticeable. However, results may vary depending on your body type, so it is best to follow the scar care instructions carefully.

Q. Can I still get a front incision if the space between my eyebrows is narrow? If the distance between the eyebrows is narrow, it is better to avoid an overly aggressive front incision. In such cases, it is more natural to consider a back incision together or to make minimal corrections through repositioning.

Q. If my epicanthic fold is severe, is double eyelid surgery alone enough? If you only get double eyelid surgery when the epicanthic fold is strong, the line may bend or create a sausage eye. Depending on the degree of the epicanthic fold, combining it with a front incision is important for creating a natural result.

In summary,

The reason the inner corner of the eyes looks crowded is most often the epicanthic fold.

If the epicanthic fold is strong → consider a front incision with the repositioning method If the space between the eyebrows is narrow → consider a back incision or minimal repositioning If you are also getting double eyelid surgery → first design the line based on the degree of the epicanthic fold

The key is not to make the eyes ‘bigger’ unconditionally, but to correct only as much as needed to match the structure of your eyes.

If the inner corner of your eyes looks crowded, we recommend visiting the clinic to accurately check the degree of the epicanthic fold.

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MOOi Plastic Surgery

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This content was written directly by MOOi Plastic Surgery Clinic for the purpose of providing information in an easy-to-understand way about procedures and surgeries, in compliance with Article 56, Paragraph 1 of the Medical Service Act. Since all procedures/surgeries may vary from person to person and side effects may occur, we recommend that you consult with the medical staff in charge before proceeding.