What are medial and lateral epicanthoplasty? How do they differ, and who is an ideal candidate?
Medial epicanthoplasty and lateral canthoplasty target two distinct anatomical areas of the eye. Understanding what each procedure entails, how they differ, and who is an ideal candidate will help you communicate effectively and precisely with your surgeon.
Quick Summary: Medial and lateral epicanthoplasty are two distinct procedures that differ in anatomical location, purpose, and scarring risk. Medial epicanthoplasty addresses the skin fold covering the inner corner of the eye (epicanthal fold/Mongolian fold), making the eyes appear longer and reducing the perceived distance between them — this carries a higher risk of visible scarring because the skin in this area is thin and under constant tension. Lateral epicanthoplasty widens the outer corner of the eye, extending the horizontal length — it is less common and harder to maintain long-term results. Neither procedure is universally suitable: eligibility depends entirely on your existing ocular anatomy.
What is Medial Epicanthoplasty?
Many Asians have an epicanthal fold (medial epicanthus). This fold partially covers the inner corner of the eye, making the eyes appear shorter than they actually are and creating the illusion of a wider intercanthal distance.
Medial epicanthoplasty modifies this skin fold to expose the inner corner (lacrimal caruncle). Typical results include: horizontally longer-looking eyes, a narrowed appearance of the space between the eyes, and a more seamless double eyelid crease along the inner corner after upper blepharoplasty.
This is why the procedure is frequently combined with double eyelid surgery: when an epicanthal fold is present, it can block the newly created eyelid crease at the inner corner, causing asymmetrical folds or an incomplete, "tucked-in" look at the inner eye.
What is Lateral Epicanthoplasty and How Does it Differ from Medial?
| Medial Epicanthoplasty | Lateral Epicanthoplasty | |
|---|---|---|
| Location | Inner corner of the eye, near the nose | Outer corner of the eye, near the temple |
| Target | Epicanthal fold at the inner corner | Lengthening the palpebral fissure outward |
| Results | Longer eyes, eyes appear closer together | Extends horizontal length at the outer corner |
| Popularity | More common, frequently paired with double eyelid surgery | Less common |
| Result Retention | More stable | Harder to maintain — tissues tend to contract back toward their original position |
| Scarring Risk | Higher — inner corner skin is thin and under mechanical tension | Lower, but still present |
Key takeaway: not everyone is an indicated candidate. For individuals without an epicanthal fold, medial epicanthoplasty provides no benefit; for those with unsuitable bone structure and palpebral fissure anatomy, lateral epicanthoplasty results are prone to relapse.
Does Epicanthoplasty Leave Scars?
To be direct: there is a more visible risk of scarring compared to double eyelid surgery, and this is an essential factor to understand before deciding.
The reason: the incision for double eyelid surgery sits within the natural eyelid crease, concealing it when the eyes are open. The incision for medial epicanthoplasty cannot be hidden in a natural fold, and it is located on delicate skin subjected to constant dynamic tension with every blink.
Influencing factors:
- Surgical technique and incision design — the surgeon's responsibility, and the most critical factor
- Your individual scar predisposition — if you have a history of keloids or hypertrophic scars on other wounds, you must inform your surgeon before surgery
- Sun protection and postoperative care — fresh scars are highly susceptible to hyperpigmentation upon sun exposure
- Degree of opening — over-resection increases wound tension, making the scar more noticeable
Who is a Good Candidate, and Who Should Exercise Caution?
Potentially Suitable Candidates
- Individuals with a prominent epicanthal fold that makes the eyes look short
- Patients undergoing double eyelid surgery where an epicanthal fold prevents a seamless inner crease
- Those whose wide intercanthal distance is caused by skin folds rather than underlying bony anatomy
Those Who Should Exercise Caution or Avoid the Procedure
- Absence of a distinct epicanthal fold — nothing to modify
- History of keloid or hypertrophic scarring
- Wide eye spacing caused by craniofacial bone structure, not skin folds — epicanthoplasty cannot correct bone morphology
- Unrealistic expectations of dramatic eye shape transformation solely through this procedure
- Active localized eye infections or inflammation
Postoperative Care — Standard Eyelid Surgery Protocol
According to BonBoz Clinic's Postoperative Care Guidelines for eyelid/periorbital surgery:
- Days 1–2: Cold compress for 10–15 minutes per session, every 1 hour. Keep your head elevated, do not touch your eyes
- Day 3: Switch to warm compresses
- Day 7: Suture removal at the clinic
- First Month: Abstain from seafood, beef, glutinous rice, water spinach, alcohol, and stimulants. No makeup, no contact lenses. Cleanse eyes gently with sterile saline, keep tap water away from the eyes. Wear sunglasses outdoors during the day, and avoid direct airflow from air conditioners into the eyes. Do not rub your eyes
- Follow-up Appointments: 1 month – 3 months – 6 months
For this specific procedure, sun protection and strictly refraining from eye rubbing are significantly more critical than usual because the incision scar is not hidden within an eyelid crease.
Contact the surgeon immediately if you experience: abnormal severe swelling, heavy bleeding or purulent discharge · fever above 38.5°C · spreading erythema/inflammation · inability to fully close the eyes after 1 week. Hotline: 0869 612 310 – 1900 5309.
References
- ASPS — Eyelid surgery, accessed 10/03/2026
- NHS — Eyelid surgery, accessed 10/03/2026
Frequently Asked Questions
Is epicanthoplasty mandatory when getting double eyelid surgery?
It is not mandatory, but it is often considered concurrently when an epicanthal fold prevents a smooth, continuous crease at the inner corner. Your surgeon will clearly explain whether your specific anatomy warrants it during the consultation.
Does medial epicanthoplasty make the eyes bigger?
Medial epicanthoplasty makes the eyes horizontally longer and exposes more of the inner corner; it does not enlarge the eyes vertically. If vertical enlargement is desired, different surgical interventions are required.
Will medial epicanthoplasty scars fade?
They do fade over time, but the risk of residual visibility is higher than with double eyelid surgery scars since there is no natural fold to conceal them. Diligent sun protection and proper early-stage aftercare are the components within your control.
Do lateral epicanthoplasty results tend to relapse?
Tissues have a higher tendency to contract back toward their original position compared to medial procedures — which is why this surgery is less commonly performed. Your surgeon will thoroughly discuss result longevity before you make a decision.
This article is for reference only and does not replace an in-person examination or a doctor's diagnosis. Actual results vary by individual condition.