An Approach To Minimally Invasive Correction Of Epicanthus With Double-eyelid Operation At The Same Time

Objective:Patients with epicanthus compose 50% Asian population and 70% single eyelid crowd. Existence of epicanthu makes length of palpebral fissure shorten and visual field blocked in severe ones. Correction of epicanthu surgery should be one of most popular surgery items in department of cosmetic and plastic surgery .In textbooks, there are many classical procedures based on various types of epicanthus, but conventional epicanthus corrections result in obvious scars lasting for a long time,which makes many clinic surgeries avoid this operation deliberately. With the epicanthus anatomical studies, we gain further understanding of anatomy source of epicanthus , clinical doctors have made many improvement of this operation. They try their best to make hidden incision even no canthal incision, lighten scar and reduce relapses.Epicanthus minimally invasive surgery is also an attempt followed these items. Through clinical validation, results of this method are satisfied for patients with epicanthus palpebral and epicanthus tarsalisMethods:From 2003 to 2008,we have treated patients with epicanthus for a total of 180 cases, among which 102 cases(204 side) were with epicanthus palpebral and 78 cases(156 side) were with epicanthus tarsalis.With a double-eyelids incision ,skin of epicanthus was separated thoroughly from orbicularis oculi,a subcutaneous tunnel was formed,the orbicularis oculis whose terminations were displaced were excised thoroughly, the skin of epicanthus was affixed to deep nasal tissue and folded inwardly, the reductus should be connected with fold of upper eyelid naturely ,the angle of eye medial.was revealed partly or totally.For the epicanthus palpebralis ,a procedure in the subcutaneous tunnel can be used to fix the subcutaneous tissue of medial canthus to the nasal deeper tissue.For the revere epicanthus palpebralis,a packaged reactor out of skin can be made to generate pressure.For the revere epicanthus tarsalis,a V-Y advancement in lower eyelid skin near medial canthus can be made to release the epicanthus skin tension in the vertical direction,at the same time ,the orbicularis muscle with dislocation below skin of palpebra inferior can be released or excised.Results:180 patients were followed up for 1 to 2 years,the epicanthus have been rectified, lacrimal caruncle been revealed,angle of eye medial be en natural and no visible scar in medial angle of eyes except for the slight surgery scar in the patients with revere epicanthus tarsalis who were taken V-Y advancement in lower eyelid skin .More than 95% patients were satisfied with the result.Only 5 cases suffered epicanthus relapses due to the loose suture line in medial angle of eye ,who were made thread embedding for repair with satisfied final results.Conclusion:In this technology,with a double-eyelid incision,effective fixation to deep plate tissue were made in a subcutaneous tunnel ,which resulted in no scar in medial zone in inner canthus in horizontal direction and lower relapse rate. The sawtooth-liking incision in double-eye reductus alleviated the skin tension of inner canthus in vertical direction and avoided a complex flap transfer. This approach provides a simple and effective way to correct the epicanthus palpebralis and epicanthus tarsalis.