Thank you for your question!
You stated in your question that you’re 21 years old and the inner corner of your
eyes bother you in a way that you feel that it ruins every picture.
And in the photos you submitted, you actually pinch the space between your nose over the
bridge of your nose to expose more of the inner corner and you feel that’s the goal
and you want to clearly know about your options.
Well, I can certainly provide you with some guidance.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon practicing in Manhattan and Long Island for over 20 years and Asian
eyelid surgery is an area of expertise in my practice and we treat patients who come
to us from around the world.
So, when it comes to this question, first, what you’re describing is variation of the
anatomic feature called an epicanthal fold.
The classification of epicanthal folds determine the type of surgical options that you can
consider.
Just from a broad perspective, I would say that your epicanthal fold is not as significant
as people who have less of what’s called the lacrimal lake or the area of the inner
corner which gets partially covered naturally by an epicanthal fold.
So when you expand the space over the bridge of your nose by pinching the skin and you
bring the corners in closer, I have to see it is a little bit exaggerated.
I’m sure you’re doing that on purpose to try to demonstrate what your desired outcome
is.
Basically, there are two ways to accomplish your goal but you also have to be aware that
there is a downside to both options.
First, we begin with pinching your nose.
You notice that when you elevate the bridge of your nose that more of the inner canthus
can be seen.
Now that means that an option that some people have taken is a rhinoplasty where a material,
usually in this country, is cartilage.
Outside of this country, people place commonly silicone implants to raise the bridge of the
nose and that can help balance things out.
The other procedure is called the epicanthoplasty.
Now epicanthoplasty, depending on the type of procedure with a type that I would consider
on you, would be a more conservative procedure is basically a set of incisions around the
epicanthal fold and it’s essentially movement of skin to allow exposure of the lacrimal
lake and that way, elongates the width of the eye.
The reason why I’m hesitant is that on a 21-year-old, I would be concerned about the
scars.
And although it is routine to do a combination of epicanthoplasty with upper eyelid Asian
blepharoplasty, I would still question whether it’s justifiable in your situation.
There have been patients who have come to us where they really wanted that particular
procedure and the initial process was a challenge because after the procedure, those scars can
get a little thick.
They may need some tender loving care (TLC) and some management and some after care but
you have to think about the motivation.
Are you willing to accept a certain risk for scars compared to the way you appear.
And so, I think that’s a very important detail and the relative risk of scarring has
some dependency on the type of skin you have.
So I recommend you meet with doctors who perform epicanthoplasty and learn about your options
but I would say, from the photo you submitted, that enough of your lacrimal lake shows that
I would probably dissuade you from pursuing surgery because I think that extra millimeters
or so that you could see the inner corner is not going to justify the risk of scars.
And I also think that from a subjective perspective that you may be over interpreting what you
describe as “ruining the pictures”.
And so, learn more, meet with doctors and learn about the options and the risks before
you pursue or commit to having a procedure done.
So I hope that was helpful, I wish you the best of luck and thank you for your question!