Epicanthoplasty is often needed during double eyelid surgery. Epicanthoplasty is needed when a patient has an epicanthal fold. This epicanthal fold is not only excess skin at the medial (nasal) side of the eye but it also contains strong fibrous tissue. This strong fibrous tissue at the medial or nasal side of the eyes creates a strong downward force that inhibits upward elevation of the eyes. Therefore, during double eyelid surgery, it is important to release this downward creating fibrous tissue and remove this excess skin as well.
If the epicanthoplasty is not performed during double eyelid surgery, the double eyelid fold will be an infold.
If a higher outfold double eyelid is created, then the presence of the epicanthal fold will create a fork. The fork is created due to the presence of an outfold and an infold at the inner corner of the eyes. Therefore, the inner eyelid will not appear clean and smooth. In addition, the epicanthal fold hinders the double eyelid fold from occurring at the inner side of the double eyelid fold. Therefore, in patients with an epicathal fold that did not undergo epicathoplasty will often have a weak double eyelid fold or a double eyelid fold that loosens at the inner corner of the eyes.
For the reasons mentioned above, it is important to release the epicanthal tissue connecting the inner corner to the upper eyelid crease and to connect the double eyelid fold to the inner corner.
By connecting the double eyelid fold to the inner corner, the patient will have a one continuous and smooth double eyelid fold at the inner corner of the eye and the region will appear larger and smoother.
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