[Real Case] Natural Adhesion, Upper Epicanthoplasty

#NaturalAdhesion #UpperEpicanthoplasty #EyeSurgery #GangnamEyeSurgery #DermalAdhesion #GangnamPlasticSurgery #Weverse #ParkSunhee #ShimJunghwan #SeoSeungjo #DermalAdhesion #DoubleEyelid #LowerEpicanthoplasty #CornerEpicanthoplasty #GangnamNaturalAdhesion #RevisionEyeSurgery

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Hello~

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Today, we will review a case of Natural Adhesion + Epicanthoplasty.

Pre-operative Analysis

The right eye has an inner double eyelid, while the left eye does not, making the eyes appear asymmetrical in size.

It also seemed like the levator muscle strength was weaker on the left, but in reality, there was no significant difference in the opening strength between both sides.

Therefore, I determined that ptosis correction was unnecessary. Instead, considering that the skin on the left eye had multiple folds

and was more saggy, the surgical plan had to be established accordingly.

For a patient like this, I believe there are two main approaches:

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1) Using the incisional method to excise a bit more skin from the left eye, or

2) Using the non-incisional method, creating a slightly higher line while performing an epicanthoplasty or upper epicanthoplasty together.

Because there are various factors to consider, this is a case where thorough consultation with the patient is crucial.

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Consultation and Surgical Process

The patient wanted a natural double eyelid look, specifically an in-line fold but with the starting point somewhat visible.

Currently, the inner double eyelid line on the right is not particularly low, but considering that there is a lot of overlapping skin making the line barely visible,

the incisional method would be better for creating a thin double eyelid feel.

However, since the patient preferred the non-incisional method, we had to raise the line. We discussed how much to raise it and decided on an appropriate height.

At this point, if an upper epicanthoplasty was not performed, the front line would be too covered,

resulting in a less aesthetically pleasing line, so I judged it best to perform them together.

Because the lacrimal caruncle exposure was insufficient, a standard epicanthoplasty could also be considered,

but since the distance between the eyes was not wide, we decided to proceed with an upper epicanthoplasty alone.

The surgical method involved creating the line using the standard natural adhesion (non-incisional) method,

followed by an upper epicanthoplasty, which dissects and removes the overlapping skin at the front of the eye.

While being careful to avoid interference with the Mongolian fold so the in-line would not change,

we removed a larger amount of skin on the left side, which had more overlapping tissue.

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Post-operative Progress

Because this is a case where the line was raised using the non-incisional method despite having overlapping skin,

there was slightly more swelling compared to a typical case.

In the immediately post-op photo, you can see the incision length for the upper epicanthoplasty.

At 1 week, scar tissue is prominent, so the front line may appear bumpy or slightly folded.

However, as time passes and it softens, the 3-month photo shows that the bumpiness has disappeared,

and the scar is barely noticeable.

Through the upper epicanthoplasty, the line extends smoothly without the front feeling covered, despite being an in-line fold.

Even without ptosis correction, because an appropriate height was established,

the patient achieved a relatively large line without the "sausage eye" appearance.

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In this post, we reviewed a case of Natural Adhesion + Epicanthoplasty.

We will continue to provide more detailed information through various case reviews in the future.

If you have any questions, please leave a comment and we will answer them.

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Frequently Asked Questions

Is double eyelid surgery possible for asymmetrical eyes without epicanthoplasty?

Yes, it is possible. If there isn't a significant difference in the opening strength of both eyes, asymmetry can be improved with natural adhesion double eyelid surgery alone, without epicanthoplasty. The case in the main text also achieved natural results by setting an appropriate line height without epicanthoplasty.

In what cases is upper epicanthoplasty recommended?

It is recommended when the inner corner of the eye line is expected to be covered by skin and not look aesthetically pleasing. By raising the double eyelid line and removing the skin that covers the front part to prevent it from looking stuffy, you can achieve a result where the inner corner extends cleanly, even with an in-line crease.

Is it possible to have front epicanthoplasty or upper epicanthoplasty even if the distance between the eyes is narrow?

Yes, it is possible with upper epicanthoplasty alone. If the distance between the eyes is not far and front epicanthoplasty is burdensome, performing upper epicanthoplasty, which involves carefully dissecting and removing only the upper skin while being mindful of interference with the Mongolian fold, can improve a stuffy eye appearance without making the glabella look narrower.

How long does it take for swelling and scar recovery after natural adhesion and upper epicanthoplasty?

Typically, scars recover to be almost unnoticeable after about 3 months. In the first week after surgery, the front line may appear bumpy or overlapping due to severe scar tissue, but over time, it gradually softens and settles into a natural double eyelid line.