Cosmetic and structural outcomes of two different techniques of medial epicanthoplasty according to epicanthal fold classification and severity: a cohort study

Publication date: Available online 19 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Guanhuier Wang, Song Zhang, Jianxun Ma, Dong Li, Hongyu Xue
AimThis study aimed to compare the cosmetic and structural outcomes of two techniques for medial epicanthoplasty of the epicanthal fold, which varied in classification and severity.MethodsMedical records and photographs of 106 patients (212 eyes) who underwent medial epicanthoplasty using the modified Z-plasty or the modified redraping technique were reviewed retrospectively. They underwent surgery from January 2009 to June 2017, and had completed the follow-up of 6 months. The cosmetic outcome was evaluated in satisfactory, symmetry, smoothness, and scarring using a four-point scoring method, and the structural outcome was assessed by the ratio of intercanthal distance (ICD) and interpupillary distance (IPD). The two surgical techniques in the same epicanthal classification and severity were compared and analyzed.ResultsThe modified Z-plasty and the modified redraping technique had similar outcomes in satisfaction level in all types of epicanthal folds. The modified Z-plasty scored significantly higher in scarring in mild, moderate, and severe epicanthus palpebralis (p=0.034, 0.028, 0.013, respectively). The modified redraping technique scored significantly higher in smoothness in mild epicanthus tarsalis (p=0.025). In epicanthus palpebralis, the postoperative ICD/IPD ratio in the redraping technique was significantly lower (p=0.001, 0.000, respectively) while the preoperative ratio showed no significant difference. In epicanthus tarsalis, the postoperative ICD/IPD ratio showed no significantly difference while the preoperative ratio was significantly difference (p=0.011, 0.002, respectively).ConclusionsThe modified Z-plasty provided less scar in epicanthus palpebralis. The modified redraping technique provided more smoothness in mild epicanthus tarsalis, and it was more efficient in shortening the intercanthal distance.