A woman is looking to enhance but not change her eyes. She wants to know if epicanthoplasty is necessary for an Asian blepharoplasty.
Dr. Amiya Prasad, an oculofacial plastic surgeon, explains that in Asian eyelid surgery, there are some variability in the doctors, their particular style, and what they see as optimal Asian eyelid surgery. He has a good number of colleagues who believe strongly in epicanthoplasty and that’s fine.
Dr. Prasad always explains to his patients that 50% of people of Asian descent will have a crease and 50% will not. So when he does his surgery, he makes a crease as if it was naturally made. In evaluating patients, he takes a Q-tip to roll the skin in to see where their physical skin would give permission to create a crease. Generally, for someone with a strong epicanthal fold, the crease flows into it. In someone with a subtle epicanthal fold, it just goes parallel or it tapers in more softly. However, epicanthoplasty changes the whole dynamic of the eyelids so that the crease goes in further and more of the inner corner of the eye is seen. From his perspective, if nature were to create a natural fold, there shouldn’t be a difference in the epicanthus and the area where it is basically the inner corner of the eye. That said, he generally doesn’t do epicanthoplasties because it doesn’t give a natural appearance.