Epicanthoplasty Using the Modified Hiraga's Method

Park, Dae Hwan; Choi, Won Seok; Song, Chul Hong

Abstract

The medical epicanthal folds on eyelids is one of the unique features of Asians. Epicanthoplasty enhances the aesthetic results of eyelid surgery by lengthening the palpebral fissure and producing the image of a larger, more open eye. Many authors described surgical procedures for correction of epicanthal folds. But most of them leave additional scars. We used to use Hiraga's method for correcting the epicanthal folds. Hiraga's epicanthoplasty is simple and practicable method. However, Hiraga's method has the disadvantage of making vertical scar on the nasal side of the lower eyelid. To overcome this disadvantage, we transposed the incision line to be paralleled with the margin of lower eyelid. We presented here a simple epicanthoplasty with minimal scar based on modified Hiraga's method with 24 cases performed during the past 3 years. A double fold operation and ptosis correction was performed along with epicanthoplasty in 18 cases and a epicanthoplasty without a double fold operation was performed in the remaining 6 cases. The follow-up period ranged from six months to two years. The results, with the exception of one case of hypertrophic scarring and one case of undercorrection, were all satisfactory. The advantages of our procedure are simplicity in design and the minimal scarring produced in the medial canthal area compared with a Hiraga's method or complex W-plasty, Z-plasty, or half Z-plasty requiring multiple incisions and often creating unsightly scarring on the medial side of lower lid. This method can be one of the effective procedures for correcting the Asian epicanthal fold because of avoiding potential visible scar on the lower lid.