Background Excessive correction of the epicanthal fold can compromise both the aesthetic shape and functional integrity of the medial epicanthus. This issue can be effectively addressed through various epicanthal fold reconstruction techniques; however, the use of unsuitable surgical approaches may lead to complications in medial epicanthal fold reconstruction. Purpose This paper is predominantly intended to introduce the V-Y tongue-shaped flap method to reconstruct the epicanthal fold and to optimize the details of epicanthal fold reconstruction. Methods This study included 89 patients (169 eyes) who experienced conventional medial canthoplasty or epicanthal fold reconstruction and underwent correction using V-Y tongue-shaped flap method from January 2018 to January 2025. Preoperative and postoperative measurements were conducted to assess both the exposure of the lacrimal caruncle and the intercanthal distance. Additionally, an investigation was carried out to evaluate patients’ postoperative satisfaction levels. Results Preoperatively, the intercanthal distance (space between the medial epicanthal folds) measured 34.68 ± 1.40 mm, whereas postoperatively, this distance increased to 36.70 ± 1.31 mm. The exposure rate of lacrimal caruncle was reduced (preoperative: 88.22 ± 6.15%, postoperative: 58.26 ± 8.36%), and the difference was statistically significant in comparison between preoperative and postoperative periods (P < 0.001). A total of 92% of patients awarded a score of ≥ 4, indicating “satisfactory” or “very satisfactory” outcomes, while 8% rated their experience as “fair”, and there were no unsatisfactory cases reported. Conclusion The proper preoperative design and tension of the medial epicanthal fold tissue will directly determine the shape and stability of the reconstructed epicanthus. The V-Y tongue-shaped flap method serves as a highly effective approach for alleviating tension in the medial epicanthal fold and achieving an aesthetically pleasing and stable inner canthal configuration. 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  <a href="http://www.springer.com/00266">www.springer.com/00266</a>.

Reconstruction of Medial Epicanthal Fold and Treatment of Some Adverse Complications Using the V-Y Tongue-Shaped Flap

期刊论文
发表日期：

2026年3月25日

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Ya-Yun Zhuang,
Ying Lv,
Tao Fang

摘要

Background

Excessive correction of the epicanthal fold can compromise both the aesthetic shape and functional integrity of the medial epicanthus. This issue can be effectively addressed through various epicanthal fold reconstruction techniques; however, the use of unsuitable surgical approaches may lead to complications in medial epicanthal fold reconstruction.

Purpose

This paper is predominantly intended to introduce the V-Y tongue-shaped flap method to reconstruct the epicanthal fold and to optimize the details of epicanthal fold reconstruction.

Methods

This study included 89 patients (169 eyes) who experienced conventional medial canthoplasty or epicanthal fold reconstruction and underwent correction using V-Y tongue-shaped flap method from January 2018 to January 2025. Preoperative and postoperative measurements were conducted to assess both the exposure of the lacrimal caruncle and the intercanthal distance. Additionally, an investigation was carried out to evaluate patients’ postoperative satisfaction levels.

Results

Preoperatively, the intercanthal distance (space between the medial epicanthal folds) measured 34.68 ± 1.40 mm, whereas postoperatively, this distance increased to 36.70 ± 1.31 mm. The exposure rate of lacrimal caruncle was reduced (preoperative: 88.22 ± 6.15%, postoperative: 58.26 ± 8.36%), and the difference was statistically significant in comparison between preoperative and postoperative periods (P < 0.001). A total of 92% of patients awarded a score of ≥ 4, indicating “satisfactory” or “very satisfactory” outcomes, while 8% rated their experience as “fair”, and there were no unsatisfactory cases reported.

Conclusion

The proper preoperative design and tension of the medial epicanthal fold tissue will directly determine the shape and stability of the reconstructed epicanthus. The V-Y tongue-shaped flap method serves as a highly effective approach for alleviating tension in the medial epicanthal fold and achieving an aesthetically pleasing and stable inner canthal configuration.

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.