Epicanthoplasty

Epicanthal fold referred to the skin fold that covers the inner corner of the eye. Epicanthal fold is common in the Oriental population but is rare among Caucasians. The presence of epicanthal fold makes the eye appears shorter and smaller than it actually is, and also makes both eyes appear farther apart from each other. For those with double eyelid crease, the tension in the epicanthal fold pulls the double eyelid crease to join the upper eyelid margin, forming a tapered double eyelid crease instead of a parallel double eyelid crease.

Epicanthoplasty is a minor surgery to remove the epicanthal fold to ‘open up’ the inner corner of the eye. The aim is to make the eye appears longer and bigger. It also helps to create parallel double eyelid crease during double eyelid surgery.

Preparation

1.    Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

2.    Stop smoking at least one week before surgery. Smoking negatively affects wound healing and increases risks of other post-operation complications.

3.    Stop the following one week before surgery:

a.  All supplements that contain vitamin E, ginseng, gingko, garlic, fish oil and other ingredients that increase bleeding during surgery

b.    Medicine that increases bleeding during surgery such as aspirin, NSAIDs and warfarin. However, you may need to consult your physician who prescribed the medicine before you stop them.

4.    On the day of surgery, wear simple and comfortable clothing. Do not wear any jewelry and metal objects on the face and body.

5.    Bring a pair of sunglasses on the day of surgery for use after surgery

6.    Don’t wear contact lens on the day of surgery

Surgery

Duration: Half an hour

Anaesthesia: Local anaesthesia

Hospitalization: Not required.

Recovery*: Back to work in 3 days, light exercise after 3-5 days, heavy exercise after 2-3 weeks.

*The speed of recovery and duration of rest may vary from person to person and also depends on the physical burden of the work and exercise the patient is going to resume.

Surgery Technique: A small incision is made around the inner corner of the eye and the epicanthal fold is removed. We employ ‘hidden-scar epicanthoplasty’ technique where the scar is located behind the eyelid margin.

Post-operative Care**

1.    What to expect: Swelling is limited to the inner corner of the eye and usually peaks on the second to third day after surgery and then gradually subsides. Post-operative pain is usually minimal.

2.    General care:

a.   Apply cold pack during the first 3 days and warm pack thereafter. Elevate the head during sleep to reduce swelling.

b.  Avoid smoking for at least one month. Smoking increases the risk of wound complications.

c.    Use sunglasses for protection when going outdoors.

d.    Get a good rest and enough sleep to speed up recovery.

e.    Be relaxed and calm. Contact the clinic if there are any queries.

f.     Don’t use contact lens for at least 1-2 weeks.

3.    Medicine: Finish the oral antibiotics as prescribed. Take the painkiller when necessary.

4.   Wound care: Clean the wound with a clean cotton tip soaked with sterile water/saline. After that apply antibiotic ointment. No dressings are required.

5.    Physical activity: Avoid heavy physical activities and exercises for at least one month.

6.    Follow-up: Come back one week after surgery for suture removal and review.

7.   Emergency: If there is heavy bleeding, rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.

**The instructions in this section are not meant to be exhaustive and are only for general references. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for specific advice.