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Types of Epicanthoplasty

Dec 31, 2021 Source: Cainiu Health
Dr. Cui Xin
Introduction
Z-plasty medial canthoplasty is a specialized flap transplantation procedure. Through surgical technique, the skin at the medial canthus is dissected to create two triangular flaps. Leveraging the inherent mobility of the skin tissue, the positions of these two triangular flaps are interchanged, thereby shifting the medial canthal point inward. After suturing and securing the skin, this procedure effectively eliminates epicanthal folds and widens the medial canthus.

Canthoplasty (eyelid corner enlargement) is a relatively common oculoplastic procedure that involves surgically widening the inner or outer canthus to create the appearance of larger, more attractive eyes. There are several types of canthoplasty, broadly categorized as medial (inner) and lateral (outer) canthoplasty. Medial canthoplasty further includes three primary techniques: Z-plasty medial canthoplasty, Speath medial canthoplasty, and Y-V advancement medial canthoplasty.

Types of Canthoplasty

Z-Plasty Medial Canthoplasty

Z-plasty medial canthoplasty is a specialized flap transplantation technique. During surgery, skin at the medial canthus is dissected to form two triangular flaps. Leveraging the inherent mobility of the skin tissue, these two flaps are transposed and interchanged, thereby shifting the medial canthal point inward. After precise suture fixation, this technique effectively eliminates epicanthal folds and enlarges the medial canthus.

Speath Medial Canthoplasty

In Speath medial canthoplasty, incisions are made in the epicanthal fold region to create four triangular flaps. These flaps are then pairwise crossed and repositioned—again utilizing skin mobility—to shift the medial canthal point inward. Final suture fixation achieves canthal enlargement.

Y-V Advancement Medial Canthoplasty

Y-V advancement medial canthoplasty involves making a Y-shaped incision at the medial canthus. A V-shaped flap is then advanced into the distal end of the Y-shaped incision, followed by V-shaped closure. This maneuver shifts the medial canthal point inward, thereby eliminating epicanthal folds and enlarging the medial canthus.

Lateral Canthoplasty (Outer Canthoplasty)

Lateral canthoplasty addresses conditions such as short horizontal palpebral fissures—where even double eyelid surgery fails to yield satisfactory improvement—or excessively upward-turned lateral canthi that impart an overly sharp or aggressive appearance. When the lateral canthus lacks upward rotation and the eye’s horizontal dimension appears narrow, lateral canthoplasty lengthens the palpebral fissure horizontally.

The above outlines the major types of canthoplasty. In fact, different techniques are suited to distinct anatomical features and individual needs; therefore, selecting the most appropriate type of canthoplasty requires careful consideration of one’s specific ocular anatomy and overall physical condition.

We hope this information has been helpful. Wishing you a joyful and fulfilling life!

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