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Background <p>Epicanthoplasty is the most common cosmetic eye surgery. However, traditional surgical strategies usually cause visible scars in the medial canthus. This study innovatively aimed to propose a modified asymmetric inverse Z-plasty derived from the traditional Z-plasty technique to minimize postoperative scars and consequently enhance patient satisfaction.</p> Methods <p>This retrospective study included 172 patients with epicanthal folds who underwent an epicanthoplasty. Group A patients (<i>n</i>&#xa0;=&#xa0;94) underwent modified asymmetric inverse Z-plasty, whereas Group B patients (<i>n</i>&#xa0;=&#xa0;78) underwent Z-plasty. Postoperative outcomes, including scarring (assessed using the Vancouver scar scale [VSS]), scar hiding degree, patient satisfaction, and recurrence rates, were evaluated at 6 months.</p> Results <p>Postoperative evaluations revealed that both groups achieved normal wound healing without infections or complications after 7 days. VSS assessments indicated superior scar outcomes in Group A patients with moderate-to-severe epicanthal folds compared with those in Group B participants. Scar hiding degree analysis demonstrated a significantly higher percentage of postoperative pure hidden scars in Group A (<i>P</i>&#xa0;=&#xa0;0.0042), particularly in moderate (<i>P</i>&#xa0;&lt;&#xa0;0.0001) and severe epicanthal folds (<i>P</i>&#xa0;=&#xa0;0.002). Patient satisfaction was significantly higher in Group A (79.8%, very satisfied) than in Group B (47.4%, <i>P</i>&#xa0;&lt;&#xa0;0.0001). However, no significant difference in recurrence rates was observed between the two groups.</p> Conclusion <p>Patients treated with modified asymmetric inverse Z-plasty exhibited superior scar hiding degree and overall satisfaction compared to those who underwent Z-plasty. Hence, modified asymmetric inverse Z-plasty is an effective treatment for patients with epicanthal folds, particularly in moderate-to-severe cases.</p> Level of Evidence IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Comparison of Modified Asymmetric Inverse Z-plasty and Z-plasty in the Correction of Epicanthal Folds

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月20日

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  • Zhiqiang He,
  • Weinan Zhang,
  • Xi Yu,
  • Hao Qin,
  • Junfei Teng,
  • Jinqing Xie

摘要

Background

Epicanthoplasty is the most common cosmetic eye surgery. However, traditional surgical strategies usually cause visible scars in the medial canthus. This study innovatively aimed to propose a modified asymmetric inverse Z-plasty derived from the traditional Z-plasty technique to minimize postoperative scars and consequently enhance patient satisfaction.

Methods

This retrospective study included 172 patients with epicanthal folds who underwent an epicanthoplasty. Group A patients (n = 94) underwent modified asymmetric inverse Z-plasty, whereas Group B patients (n = 78) underwent Z-plasty. Postoperative outcomes, including scarring (assessed using the Vancouver scar scale [VSS]), scar hiding degree, patient satisfaction, and recurrence rates, were evaluated at 6 months.

Results

Postoperative evaluations revealed that both groups achieved normal wound healing without infections or complications after 7 days. VSS assessments indicated superior scar outcomes in Group A patients with moderate-to-severe epicanthal folds compared with those in Group B participants. Scar hiding degree analysis demonstrated a significantly higher percentage of postoperative pure hidden scars in Group A (P = 0.0042), particularly in moderate (P < 0.0001) and severe epicanthal folds (P = 0.002). Patient satisfaction was significantly higher in Group A (79.8%, very satisfied) than in Group B (47.4%, P < 0.0001). However, no significant difference in recurrence rates was observed between the two groups.

Conclusion

Patients treated with modified asymmetric inverse Z-plasty exhibited superior scar hiding degree and overall satisfaction compared to those who underwent Z-plasty. Hence, modified asymmetric inverse Z-plasty is an effective treatment for patients with epicanthal folds, particularly in moderate-to-severe cases.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.