The eyes are one of the body parts that play a crucial role in determining first impressions and appearance. As such, even small changes can significantly improve one's image. Particularly as wearing masks has become mandatory due to the coronavirus, the role of the eyes has become more prominent, leading many people to consider eye surgery they have been contemplating for some time. Among the various types of eye surgery, the most popular is 'double eyelid surgery,' which creates a double eyelid line to produce a more defined eye shape.

While double eyelid surgery is a widely popular procedure considered relatively simple, there are cases where it is difficult to expect 100% effectiveness from the surgery alone. If the eyes are covered by epicanthal folds, are horizontally short, or are too small, it is recommended to combine the surgery with appropriate customized epicanthoplasty rather than proceeding with double eyelid surgery alone.

What is 'Mongolian Fold'?
The 'Mongolian fold' is commonly found in East Asians, including Koreans. Its accurate formal name is the 'inner corner fold' or 'medial canthal fold,' and it is referred to as the 'Epicanthal Fold' in English. Although the word 'Mongolian' carries racial prejudice, it has become ingrained in our culture, much like the Mongolian spot, and is still frequently referred to as the 'Mongolian fold.'

“Epicanthal fold eyes might require parallel surgery”
If epicanthal folds make the eyes look constricted or give a particularly sharp impression, they can be removed softly and naturally by opening the inner corners of the eyes. However, by considering individual characteristics such as the caruncle and the amount and shape of the epicanthal folds, and performing double eyelid surgery in conjunction with appropriate epicanthal fold widening, a larger and more distinct eye shape can be created.

It is not uncommon to see patients seeking only epicanthoplasty without double eyelid surgery. While I understand the patient's desire, epicanthoplasty alone cannot make the eyes appear larger. Therefore, depending on the specific goal, I recommend combining it with other eye surgeries such as double eyelid surgery or eye shape correction. If your eyes are on the smaller side, it is advisable to perform appropriate epicanthoplasty alongside double eyelid surgery to increase the horizontal length of the eyes.

There is a suitable eyelid surgery for my eyes.
There are various eye widening surgical methods, such as epicanthoplasty, upper canthoplasty, lateral canthoplasty, and lower canthoplasty, where the specific area to be widened varies depending on the eye.

Lateral Canthoplasty and Lower Eyelid Surgery: Lateral canthoplasty is a surgery that widens the horizontal width of the eye by opening up the outer corner of the eye. It involves making an incision in the outer canthus to extend the horizontal length. Lower eyelid surgery involves making an incision in the inner conjunctiva of the lower eyelid to lower the corner of the eye. When combined with lateral canthoplasty, this procedure makes the eyes appear more open and lowers the corners, which can soften a sharp facial impression.

Epicanthoplasty: The most commonly performed epicanthoplasty is a surgery that naturally widens the oblique epicanthal fold covering the inner corner of the eye from the upper eyelid. If the eyes are far apart or the inner corners of the eyes appear constricted, this procedure can lengthen the horizontal width and increase the size.

As this is the most commonly performed eyelid widening procedure, many people visit the clinic for consultations regarding revision surgery. Side effects include severe scarring, 'U-shaped deformation,' 'asymmetry,' and 'excessive exposure of the lacrimal caruncle.' These are typical side effects that occur when excessive resection is performed without considering the overall harmony of the face.

The eyes are the part that determines our impression. Even a difference of just 1mm can significantly alter the atmosphere or overall impression. Therefore, it is crucial to perform epicanthoplasty and double eyelid surgery tailored to your specific eye characteristics and shape. If you undergo double eyelid line or epicanthoplasty that does not suit your eyes, it becomes difficult to achieve results that harmonize with your entire face, ultimately leading to lower post-operative satisfaction. Furthermore, if the skin around the epicanthal fold is not properly excised or is excessively removed, functional side effects may occur, or the red tissue at the inner corner of the eye may become too exposed, potentially requiring revision surgery. Therefore, it is essential to consult thoroughly with experienced medical professionals before deciding on surgery.

Written by Director Do Eon-rok (Plastic Surgeon)