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By W. Chen
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Extra info for Asian blepharoplasty and the eyelid crease
Epicanthus. Am J Ophthalmol 1968;66:939–946. 19. Boo-Chai K. The Mongolian fold (plica Mongolia). Singapore Med J 1962;3:132–136. 20. Lessa S, Sebastia R. Z-epicanthoplasty. Aesth Plast Surg 1984;8:159–163. 21. del Campo AF. Surgical treatment of the epicanthal fold. Plast Reconstr Surg 1984;73:566–570. 22. Chen WPD. Asian blepharoplasty. Ophthalmol Plast Reconstr Surg 1987;3:135–140. 23. Chen WPD. A comparison of Caucasian and Asian blepharoplasty. Ophthalm Pract 191;9:216–222. 24. Kawai K, Imanishi N, Nakajima H, et al.
Each variation has pros and cons that needs to be weighed according to the technical skills, aesthetic sense and level of effort involved, as well as the patient’s comfort level and acceptance. For example, both the skin incision and the skin excision schools favor making an incision to accurately deﬁne the placement of the crease. These practitioners are comfortable with these techniques as well as the wound healing process, and are likely to be less concerned about instant recovery. Specialists who routinely open the orbital septum are likewise comfortable with the anatomic landmarks and aim to clear the preaponeurotic zone along the superior tarsal border.
3-15). This crease is often too high, unnatural, and harsh (termed the ‘huh’ syndrome). A high crease is one located 10–12 mm from the ciliary margin. A high crease may result if a surgeon adheres to an empiric formula for the height of the lid crease, or uses techniques of supratarsal fixation in which a distance of 10 mm or more is applied without regard to ethnicity. Either method results in a crease that looks excessively high on an Asian patient. 5 mm in height on average. • The distance between the eyebrow and the upper lid margin is smaller on Asians than on Caucasians.
Asian blepharoplasty and the eyelid crease by W. Chen