From the Ninth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Ann Plast Surg. 2022 Jul 1;89(1):17-22. doi: 10.1097/SAP.0000000000003209. Epub 2022 May 28.
Traditional coronal Z-epicanthoplasty usually generates visible scars, and V-Y advancement or skin redraping can damage the normal shape of the lower eyelid. In addition, these methods usually lead to loss of the medial canthus depth, which is important for the natural appearance of East Asians. This report aims to describe a 3-dimensional Z-epicanthoplasty that can maintain the depth of the medial canthus with fewer visible scars.
Patients who underwent 3-dimensional Z-epicanthoplasty from January 2016 to December 2019 were included. In our method, excess skin in the horizontal direction was first rotated to the vertical position and then turned inward from a coronal to a sagittal orientation to supplement the skin deficiency of the medial canthus in the sagittal orientation. The skin flap turned in the sagittal orientation and maintained the depth of the medial canthus and the natural appearance of the eye.
In total, 138 patients were included, and the follow-up interval ranged from 6 to 36 months. After the surgery, the epicanthi were removed, and the shapes of the patients' eyes were significantly improved and appeared natural. The surgical scars were hidden in the sagittal orientation rather than in the coronal orientation, which cannot be seen easily. The depth of the medial canthus was well preserved without any lower eyelid destruction. Patients were satisfied with the natural appearance of the medial canthus.
This method could not only correct the epicanthal fold effectively with scars that are less visible but also maintain the depth of the medial canthus and make the appearance of the eye look more natural.
传统的冠状 Z 成形术通常会产生可见的疤痕，而 V-Y 推进或皮肤重新折叠会破坏下眼睑的正常形状。此外，这些方法通常会导致内眦角深度的丧失，这对于东亚人的自然外观非常重要。本报告旨在描述一种 3 维 Z 成形术，它可以在保持内眦角深度的同时减少可见的疤痕。
纳入 2016 年 1 月至 2019 年 12 月期间接受 3 维 Z 成形术的患者。在我们的方法中，首先将水平方向的多余皮肤旋转到垂直位置，然后从冠状位向内旋转到矢状位，以补充矢状位内侧眼角的皮肤不足。向内旋转的皮瓣保持了内眦角的深度和眼睛的自然外观。
共纳入 138 例患者，随访时间为 6 至 36 个月。手术后，内眦赘皮被去除，患者的眼睛形状明显改善，显得自然。手术疤痕隐藏在矢状位，而不是冠状位，不易察觉。内眦角的深度得到很好的保留，没有破坏下眼睑。患者对内侧眼角的自然外观很满意。
该方法不仅可以有效地纠正内眦赘皮，而且疤痕不明显，还可以保持内眦角的深度，使眼睛的外观看起来更加自然。
