A Scar Comparative Study Of Three Epicanthoplasty After Complete Tension Release

Background:Scar hyperplasia after epicanthoplasty,especially in the medial canthus,has always been a tricky challenge.In recent years,in order to reduce the formation of postoperative scar,scholars at home and abroad have explored innovative techniques and applied them to epicanthoplasty,including the principles of reducing tension and conceiling incision.However,scarless healing still cannot be achieved.However,there has been no comparative study on scar after medial canthotomy with different flaps after complete tension release.Objective:A retrospective analysis of three kinds of flaps for correction of severe epicanthus,eyelid type and tarsal type epicanthus after completely releasing the tension of the inner canthus,and a comparative study of the medial canthus scar.Methods:From January 2018 to December 2021,207 patients with severe epicanthus corrected in the Department of Plastic and Aesthetic Surgery,the First Hospital of Jilin University were retrospectively analyzed.The patients were randomly divided into three groups,including eyelid margin incision method,Mustarde method and Z-plasty method.There were 84 cases of eyelid margin incision method,61 cases of Mustarde method,and 62 cases of Z-plasty method.The three surgical methods were the tension-free experimental group,and the reference was the control group.The Horizontal Lid Fissure Length was compared between the two groups.HLFL),Intercanthal distance(ICD),HLFL/ICD,modified Vancouver Scar Scale(VSS)and patient satisfaction rate were recorded.Results:There was no infection,hematoma,flap necrosis,eyelid ectropion,ptosis,lacrimal canalicular injury and other postoperative complications.There was no recurrence of epicanthus and the shape of the inner canthus was good.In the experimental group,the scar on the inner canthus was obvious 1 month after operation,and the scar on the incision was not obvious 6 months and more than 6 months after operation,which was similar to the surrounding skin color.The overall satisfaction rate of the three groups was high.By comparison of each group,it was found that as long as the tension of the inner canthus was completely released during the operation,no matter which operation method,there was no obvious scar left in the long-term follow-up.Conclusions:1.The three kinds of flaps have good correction effect on severe epicanthus,but compared with the Mustarde method,the flaps are complicated and the scar is obvious in the early stage;2.Under the condition of complete release of tension,the three kinds of epicanthoplasty have no obvious scar after operation,and the postoperative recurrence is not easy,and the patient’s satisfaction is high.