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2025.12.01
What is epicanthoplasty? ⸻ Surgery to release the epicanthal fold and refine the eye shape
As a board-certified plastic surgeon, I have handled numerous cases involving trauma, reconstruction, and congenital conditions, cultivating precise techniques and deep anatomical understanding. Driven by the desire to deliver the transformative power of beauty—where visible change uplifts the spirit—I pursued a career in cosmetic surgery. My areas of expertise include comprehensive eye treatments, injectable therapies, and anti-sagging procedures. Guided by a commitment to sincerely address each patient's aspirations, I provide meticulously crafted treatments focused on achieving beauty.
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Designing natural beauty with trust.
I am Masataka Fujihashi, a board-certified plastic surgeon.
Incisional epicanthoplasty is a procedure that involves incising and releasing the "epicanthal fold" located on the inner side of the upper eyelid to create a more defined appearance of the inner corner of the eye.
The Mongolian fold is common among East Asians, including Japanese, and when it is pronounced,eyes appear wide-set、Double eyelids tend to become fan-shaped、The inner corners of the eyes become rounded, creating a youthful impression.、This leads to such characteristics.
By performing an epicanthoplasty,The width of the eyes expands,Improves wide-set eyes,Makes it easier to create parallel double eyelids,Gives a sophisticated, mature impression,You can achieve effects such as:
On the other hand, achieving a natural finish that minimizes visible scarring requires precise design based on an understanding of the structure of the epicanthal fold and meticulous suturing.
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■ Z-plasty (Z-plasty)｜The most standard surgical technique that allows for the greatest variation
The Z-plasty is a classic surgical technique that has been performed for many years, involving the design of an incision line in a zigzag pattern.
This method effectively releases tension in the Mongolian fold and facilitates greater change.
● Benefits
• Can reliably remove the Mongolian fold
• Works well with parallel double eyelids
• Sharp, upturned inner corners of the eyeseasy to make
● Disadvantages
• Redness tends to be noticeable early on because the wound appears on the front side.
• Not suitable for people prone to scarring
• The natural look varies depending on the design and stitching
There are two main variations of the Z method.
① Z-forming
By aligning the incision with the ridge of the Mongolian fold, it creates a concave surface, effectively releasing the tightness.
However, when the Mongolian fold is large, the scar may spread diagonally, requiring careful design considerations.
Use Cases:
• I want sharp inner corners of my eyes
• The Mongolian fold is not prominent
• I want to make sure I show real change
② Half-Z Formation
Similar to the Z-plasty technique, but the design does not align one side of the Z with the crease of the epicanthal fold.
Its key feature is the ease of fine-tuning the direction of the Mongolian fold (horizontal, downward slant, etc.).
Use Cases:
• I want to make fine adjustments to the direction of the Mongolian fold.
• Desiring a natural change
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■ Ridrap Method｜The Latest Surgical Technique for Significantly Less Visible Scars
The Ridley method is a technique that reshapes the face by detaching the epicanthal fold along with the skin and repositioning it.
Because it avoids making a Z-shaped incision, the scar is hidden along the eyelid's edge, resulting in a very natural appearance.
● Benefits
• Scars are significantly less noticeable
• Relatively natural from the very start
• Suitable for minor adjustments such as revisions from other clinics
● Disadvantages
• Sharp, upturned inner corners are difficult to create and often end up rounded.
• The amount of change is modest
• Requires advanced technical skills and shows significant variation depending on the practitioner
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■ How to Choose a Technique｜Not About Superiority“Compatibility is important
The Z-plasty, half-Z formation, and Ridley flap techniques each have their own distinct characteristics.
Not which one is superior,Which one is best for your eye area?is the most important.
Guidelines for Selecting Surgical Procedures
• Parallel double, solid variation → Z-method or Half-Z-method
• Minimize damage → Ridley's method
• Natural changes and fine-tuning → Ridley method or Half-Z method
• Significant asymmetry → Either surgical approach is possible depending on the design
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■ Summary
Incisional blepharoplasty is a procedure that creates significant changes with minimal incisions.
Each surgical technique has distinct characteristics, so the optimal method varies depending on the strength of the epicanthal fold, the desired double eyelid shape, facial balance, and the desired impression.
"I want to change naturally," "I want to correct asymmetry," "I want parallel double eyelids."
For any concern you may have, we will carefully examine the structure during your consultation and propose the approach that best aligns with your ideal outcome.
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【Profile】
Masataka Fujihashi, MD, Plastic Surgeon
Leveraging expertise as a board-certified plastic surgeon, I offer comprehensive facial cosmetic procedures including eyelid and nose surgery, facial liposuction, thread lifts, and hyaluronic acid injections. From incisional surgeries and revision procedures requiring delicate design to minimally invasive injections and lifts with minimal downtime, I strive to provide treatments tailored to each patient's ideal outcome.
We are dedicated to achieving natural results and minimizing downtime, pursuing medical care that leaves you feeling confident in your choice through sincere consultations.
Designing natural beauty with trust.
We cherish that sentiment and apply it to our daily practice.
Read other blog posts ▼
https://biancaclinic.jp/author_cat/fujihashi/
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【Career】
March 2015: Graduated from the School of Medicine, Showa University
April 2015 Showa University Yokohama Northern Hospital Initial Clinical Training
April 2017 Showa University Hospital Department of Plastic Surgery
October 2017 Maebashi Red Cross Hospital Plastic Surgery / Cosmetic Surgery
April 2019 Nishio Municipal Hospital Plastic Surgery Department
April 2020 Showa University Fujigaoka Hospital Plastic Surgery Department
November 2020 Ota Nishinouchi Hospital Plastic Surgery / Cosmetic Surgery
July 2022 Tokyo Rosai Hospital Plastic Surgery / Cosmetic Surgery Department Head
July 2022: R.O.clinic (Part-time), Kusano Taro Clinic (Part-time)
April 2024 Deputy Director, Ginza TA Clinic
November 2025 BIANCA CLINIC
【Professional Affiliations and Qualifications】
Japanese Society of Plastic and Reconstructive Surgery Board-Certified Plastic Surgeon
Member of the Japanese Society of Aesthetic Plastic Surgery (JSAPS)
Member of the Japanese Society of Aesthetic Surgery (JSAS)
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