Lazy S-curve Epicanthoplasty in Asian Blepharoplasty

Abstract

Ethnic characteristics of the Asian upper eyelid include the lack of a superior palpebral fold, excessive fat, laxity of pretarsal skin, and a medial epicanthal fold. We present the lazy S-curve epicanthoplasty for correction of the medial epicanthal fold. The lazy S-curve incision was made as an entrance step. Then the connective and orbicularis oculi muscle dense fibers underlying the epicanthal folds were released and shifted. To reduce the tension of the new medial canthus, we anchored the canthus by suture fixation of both the subdermal and medial orbital periosteum. Rotation of the S-curve flap was settled as the last step. From December 2005 to December 2009, the authors corrected the epicanthal folds on the eyelids of 156 Asian patients using the lazy S-curve epicanthoplasty. Results were satisfactory in most of the follow-up cases. Lazy S-curve epicanthoplasty is a reliable and effective method to eliminate not only the epicanthal fold but also the undesirable orbicularis oculi muscle.