Prominent epicanthal folds in Caucasian (Photo)

Question

Hi, I am a Caucasian woman with very prominent epicanthal folds. I have always had (and hated) them. I feel such prominent folds make me look permanently tired due to the shadowing it creates both under my eyes and in the ‘gap’ if I was to turn my head to the side. I have had tear trough filler but can’t see much of a difference, although I only had 1ml. Looking for any recommendations on what might help please as I feel so unattractive any time I look in the mirror/see a photo of me

Gary M. Horndeski, MD · Answer

You need epicanthal fold release.  This is a surgical procedure and can possibly be done under local anesthesia.

Best Wishes,

Gary Horndeski, M.D.

Mats Hagstrom, MD (license on probation) · Answer

This is a difficult procedure.
Attempting to get significant skin lengthening will be at the cost of tightening skin in a perpendicular direction.
These procedures are typically done with various letter flaps(Z plasty, W plasty, Y plasty)In the end, the question that should be on everyone’s mind before contemplating these procedures since they are irreversible, and permanent is, is the end outcome going to look better than where you started.
I would take a conservative approach, and the first step should be finding providers who have proven track record doing this procedure multiple times in the past.
 I would not consider scheduling surgery until you meet a provider who can show you a solid track record, including a significant number of before, and after pictures of previous patients who had the same problem.
It’s not a common procedure, but to find someone who can do the work consistently they should be able to show you at least 10 sets of before and after pictures.
Most likely oculoplastic surgeons are the way to go, but you can consult with facial plastic surgeons or plastic surgeons.
You can try reaching out to each office asking how much experience the provider has with doing this procedure, though the people answering the phone and emails may not be able to tell you.
If you can get the email contact of the actual provider, that may be a good way to initially screen who you should be consulting with.
 Provider selection may take some time.
I suggest you give yourself a year to find the best provider if you’re going to consider having surgery.
My best recommendation to you is to not have surgery until you are certain you’re in the hands of someone who knows how to do these procedures well.
My second recommendation is to put in a significant amount of effort not looking at the Internet, but talking in person to plastic surgeons who seem to have some appreciable amount of experience doing these procedures.
 I personally would be looking at having at least five or six consultations before considering choosing a provider and scheduling surgery.
This type of procedure can easily end up looking worse. And the hands of the right provider you’ll get straight answers and have the Best shot at getting an improvement that justified having the procedure.
Best,
Matt Hagstrom, MD

Prominent epicanthal folds in Caucasian (Photo)

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