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Aesthetic
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Epicanthal folds – tarsalis (more prominent in the upper lid, ‘normal’ variant of Asian eyelid); palpebralis (upper and lower equally); inversus (predominant in the lower lid, feature of blepharophimosis ptosis epicanthus inversus [BPEI] syndrome). There are several common epicanthoplasty methods (Figure 10.3)
Reconstruction of full width, full thickness cicatricial eyelid defect after eyelid blastomycosis using a modified tarsoconjunctival flap advancement
Published in Orbit, 2022
Aaron R. Kaufman, Chau Pham, Peter W. MacIntosh
The patient subsequently underwent reconstruction of the right lower eyelid defect using a tarsoconjunctival flap (Hughes flap) advancement9 (Figure 3A) with modified flap connections due to cicatricial changes. Temporally, a lateral canthotomy and cantholysis were performed to access the lateral orbital rim and create a periosteal flap (Figure 3B) that was sutured to the temporal edge of the tarsoconjunctival flap (Figure 3C). Conjunctival tissue from the inferior extent of the cicatrix was released with dissection and advanced superiorly to meet the tarsoconjunctival flap. Nasally, no discernable medial canthal tendon tissue was identified; thus a flap with firm adherence to underlying periosteum was fashioned from the subcutaneous scar tissue and provided the medial anchor point for the tarsoconjunctival flap. (Figure 3D) An adjacent tissue transfer was conducted using a Mustardé four-flap epicanthoplasty12,13 in order to repair the epicanthal web. The remaining anterior defect was closed using a 2 cm x 4 cm full thickness skin graft harvested from the left postauricular skin space.
Upper blepharoplasty: advanced techniques and adjunctive procedures
Published in Expert Review of Ophthalmology, 2023
Parya Abdolalizadeh, Mohsen Bahmani Kashkouli, Vahid Khamesi, Nasser Karimi, Hossein Ghahvehchian, Leila Ghiasian
Medial epicanthoplasty can be performed with internal or external techniques. Internal approach (anchor epicanthoplasty) is for mild-to-moderate grades of epicanthal folds and is performed by extending UB incision medially with no additional skin incision and scar (Figure 5) on the side of the nasal bridge [9,110]. More severe forms of epicanthal fold, however, require extra incisions (w, z, etc.) on the sides of the nose [9,106–110]. This, external epicanthoplasty is often ensued by skin scars (Figure 5) [106].