A Simplified Treatment for Mild to Moderate Epicanthal Folds

Abstract

Summary: Surgical treatments to the upper eyelid have evolved along with a better understanding of the aging upper eyelid anatomy and development of solutions that are aesthetically pleasing and that defy detection. It is not uncommon for patients to present before or after upper blepharoplasty with perceived deformities of the medial canthus. Epicanthal folds are sometimes a concern. Approaches to the varied presentations of epicanthal folds have derived from the belief that they relate to a dermal or orbicular (muscle) issue, and solutions have primarily involved traditional approaches to altering skin and muscle tension by means of complex flaps. Complications or unfavorable outcomes that relate to this approach mainly involve scarring or nonresolution. The author describes a novel and simple surgical approach for the treatment of mild to moderate epicanthal folds or medial canthal webbing that is in line with the goals of the balance of aesthetics, resolution, and undetectability.