Do scars remain after medial canthoplasty? What research reveals about the progression

The main concern with medial canthoplasty is scarring, but research is examining methods to make scars less noticeable through surgical technique refinements and postoperative care[1][2]. On the other hand, strong long-term evidence comparing which method is superior is still limited. Let's organize what is known and what remains unknown.

What surgical techniques are used for medial canthoplasty?

Methods to reduce the medial fold (epicanthal fold) include Z-plasty, V-Y advancement, W-plasty, and others[3]. The common principle is to reorient the skin and stretch the scar to make it less noticeable. In recent years, techniques that stabilize results by repositioning skin without excessive removal (skin-redraping) have also been reported[4].

How much scarring and relapse occurs?

Scar appearance varies depending on constitution and surgical technique. Research comparing a modified Z-plasty with traditional Z-plasty examines the balance between fold correction and scarring[5]. Reviews summarizing methods to make scars less noticeable indicate that the design of incision and suturing techniques affect outcomes[1].

What points stand out regarding evidence for scar management?

One notable approach to postoperative scar management is early-stage use of botulinum toxin. A high-quality randomized controlled trial comparing the two sides of the eyes demonstrated its effectiveness in preventing raised scars (hypertrophic scarring) after medial canthoplasty[2]. However, this is not necessarily needed for everyone; decisions are made based on individual constitution and healing progression.

What are the limitations revealed by research?

Let's honestly acknowledge what remains unknown. There are not many studies directly comparing surgical techniques over the long term, and it is currently difficult to conclusively determine which method is optimal for everyone[1]. Additionally, there is considerable individual variation in how scars develop, and research results may not directly apply to your own case.

What to confirm during consultation

Important points to confirm are which surgical technique suits your medial canthus, whether you have a constitution prone to scarring, and if needed, how to combine scar management approaches[1][2]. It's reassuring to receive an explanation that includes the possibility of relapse or revision. Having your physician examine your eye area and eyelid condition, and aligning expectations about the balance between minimal visibility and change, is the starting point.