Reconstruction of medial epicanthal fold using v-y advancement and turnover flap

J Plast Reconstr Aesthet Surg. 2020 Feb;73(2):363-368. doi: 10.1016/j.bjps.2019.07.013. Epub 2019 Aug 7.


Background: Since the 1900s, many methods have been developed to correct the epicanthal fold. Increased use of epicanthoplasty has yielded unsatisfactory results.

Objectives: To describe a method of epicanthal fold reconstruction using V-Y advancement and turnover flap for clinical application. This method is simpler than conventional surgery. It is easy to perform with excellent esthetic results.

Methods: The authors performed medial epicanthal fold reconstruction in 82 patients (16 males and 66 females) between April 2014 and September 2017. All patients enrolled in this retrospective study underwent surgical procedures at the authors' institution. Interepicanthal distance was the distance between medial epicanthal folds. It was measured with a surgical ruler.

Results: Before surgery, mean interepicanthal distance was 35.4 mm. Using our surgical technique, successful outcome was achieved in 79 (96.3%) patients with satisfactory results. The mean distance between the medial epicanthi post-surgery was 38.6 mm, increasing the total length by 3.2 mm without showing any major postsurgical complications.

Discussion: Epicanthal fold reconstruction using V-Y advancement and turnover flap is a simple and effective technique that can readily improve the frontal view. It improves periorbital contouring, makes eyes look natural without fully showing the caruncle, and yields excellent esthetic results. In particular, there were no major visible scars following eversion suture.

Keywords: Epicanthoplasty; Medial epicanthal fold; Reconstruction; Turnover flap; V-Y Advancement flap.

MeSH terms

  • Adolescent
  • Adult
  • Blepharoplasty / methods*
  • Eyelids / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Surgical Flaps*
  • Young Adult