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2025.07.19
Which inner corner blepharoplasty technique is best? What about scarring and downtime?
A dual-specialty doctor with a background in plastic surgery, bridging cosmetic surgery and ophthalmology. At the university hospital, he performed numerous high-difficulty cases, primarily focusing on eye and facial bone surgeries, cultivating precise techniques grounded in anatomy. He prioritizes achieving both aesthetic beauty and functional safety, offering customized treatments around the eyes that incorporate ophthalmological expertise. He actively utilizes not only incisional surgery but also non-invasive procedures like hyaluronic acid injections. By carefully assessing each individual's condition and unique appeal, he provides bespoke treatments that guide patients toward naturally harmonious, well-defined eyes.
Hello, I'm Ryutaro Natsume, a plastic surgeon specializing in impression design.
Today's theme is...Inner Canthus Surgery is.
The essential requirement for a sophisticated, mature look: ”eyes without epicanthic folds.”
The epicanthal fold is characteristic of Asians and gives a youthful impression. If the epicanthal fold is pronounced, even with double eyelid surgery, it won't result in a beautiful mixed-type double eyelid or parallel-type double eyelid.
”I'm curious about epicanthoplasty, but I'm worried about the scarring with incision-based procedures...”I imagine many people hesitate.
Introducing the inner canthus surgery procedure, including an explanation of scarring and the recovery timeline!
Causes of Mongolian Folds
Not only the skin forming the epicanthal fold, but also the orbicularis oculi muscle beneath it along the fold is well developed.
The key to treatment lies in how to break down and release that tension.
Incisional Blepharoplasty
・Z-formation
This has been the mainstream surgical procedure in Japan for some time.
Make a Z-shaped incision in the skin at the inner corner of the eye and suture it as if replacing the skin flap.
Do not manipulate the orbicularis oculi muscle.
This is an actual case.
Benefits:
The magnitude of change is large
Prone to developing sharp, triangular inner corners of the eyes
Easy to create parallel double eyelids
Disadvantages:
Immediately after surgery, a scar will be visible on the front side (i.e., the immediate postoperative scar will be slightly noticeable).
・Ridlap Method (Korean-style epicanthoplasty)
This surgical procedure was proposed in South Korea.
The epicanthal fold skin is excised in a triangular shape, and the orbicularis oculi muscle directly beneath it, which causes the epicanthal fold, is also excised in a crescent shape.
Internal fixation is performed to secure the ligaments and skin, preventing retraction, followed by suturing.
The following is an actual case.
Benefits:
Scars are concealed along the eyelid margin (meaning they are less noticeable immediately after surgery)
The inner corners of the eyes take on a rounded shape for a natural transformation.
Disadvantages:
Sharp inner corners of the eyes are difficult to create.
It is difficult to achieve parallel double eyelids.
The Ridley method is not yet widely adopted in Japan.
Patented in China as a modified Ridley procedure that leaves less scarring
China's Top Eye Area Plastic Surgeons Neighborhood AssociationDr. Jun (Aiding Plastic Surgery) I visited and received special instruction.
We select surgical procedures based on patient preferences, but when patients strongly desire thorough removal of the epicanthal fold and a more defined appearance, Z-plasty is frequently chosen.
The technique that leaves no scars even with Z-plasty is,
We take care to avoid damaging tissue unnecessarily during surgical procedures, performing subcutaneous dissection to replace flaps and suture them in a tension-free state.
You can see from the actual case photos that the scars are barely noticeable in either case.
Regarding Downtime
Postoperative Day 1: Bleeding and swelling present
Day 1–2: Peak swelling
5 to 7 days after surgery: Suture removal
One month post-op: Redness naturally subsides
About Pain
There is a slight stinging pain during local anesthesia, but no discomfort during the surgery.
After the procedure, pain is minimal with oral pain medication.
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※There are various approaches to aesthetic medicine, and opinions and practices may differ among physicians. Please consider the information provided here as one reference only, and we hope you will choose medical care that suits you and meets your expectations.
We apologize if any unintended inaccuracies or misleading expressions were included. In such cases, we will make appropriate corrections or additions.
【Profile】
Plastic Surgeon Dr. Ryutaro Natsume
https://biancaclinic.jp/doctor/natsume/
Performed numerous facial surgeries, particularly focusing on the eye area and facial bones, in the field of plastic surgery.
Regarding treatments for the eye area, I believe that not only aesthetic appearance but also ophthalmic functionality is extremely important. To provide safer and more reliable treatments, I am currently deepening my expertise as an ophthalmologist.
We actively incorporate non-surgical procedures such as hyaluronic acid injections, in addition to treatments requiring surgical instruments.
From a multifaceted professional perspective encompassing cosmetic surgery, cosmetic dermatology, reconstructive surgery, and ophthalmology
BIANCA CLINIC, a leading Japanese clinic specializing in beauty and regenerative medicine, provides the latest aesthetic treatments.
【Career】
2020: Graduated from Tokyo Medical University Tokyo Metropolitan Saiseikai Central Hospital
2022 Jikei University Hospital Department of Plastic Surgery
2023 Department of Plastic Surgery Jikei University School of Medicine Kashiwa Hospital
2024 BIANCA CLINIC
【Professional Affiliations/Qualifications】
Japanese Society of Aesthetic Surgery (JSAS)
Full Member of the Japan Society of Plastic and Reconstructive Surgery
Full Member of the Japanese Society of Craniofacial Surgery
Full Member of the Japanese Ophthalmological Society
【SNS】
Instagram account
https://www.instagram.com/dr.natsume?igsh=OHBvd3VtajV1bmY1&utm_source=qr
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