A Modified Z-Epicanthoplasty Combined With Blepharoplasty Used to Create an In-Type Palpebral Fissure in Asian Eyelids

An epicanthal fold is common in the eyelids of Orientals, weakening the aesthetic appearance of blepharoplasty. Many techniques have been designed to eliminate the epicanthal fold and create a beautiful palpebral fissure with less scarring produced in the medial canthus. However, many of these procedures were designed to correct the epicanthus completely and create an out-type of palpebral fold, which leaves a minor scar in the epicanthus and an unnatural eye appearance. Thus, based on dynamic mechanisms, a beautiful design of the epicanthus, and a double fold in most Asian people, a new modified Z-plasty procedure combined with blepharoplasty to create an in-type of palpebral fissure was performed for 873 patients in our hospital from September 2006 to November 2010. The procedure showed good and natural results in most Asian patients. No recurrence of the epicanthal fold and no scarring of the medial canthus were found during a 6-month follow-up period. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .