Opening the inner corner of the eyes

Opening the inner corner of the eyes
Many patients come in for a desire to open the inner corner of their eyes.  They request epicanthoplasty after doing some internet searches.  However, epicanthoplasty alone rarely achieves real significant opening of the inner corner of the eyes.  Epicanthoplasty was designed to release the tight banding (thickened collagen tissues) that prevents the double eyelid fold from occurring at the inner corner.  Epicanthoplasty does remove excess skin and does open the inner corner but not as effectively as one can achieve with concurrent double eyelid surgery and ptosis surgery.  Often the patient has had double eyelid surgery or has a natural small double eyelid fold.  In these patients, they would benefit from a higher double eyelid fold with epicanthoplasty.  A higher double eyelid fold will clear the excess inner (medial) upper eyelid skin.  This is not to be confused with the inner corner of the eyes.  So rather than just opening the inner corner with the epicanthoplasty, improving (clearing) the inner upper eyelid skin will add to the desired inner eye region opening.  Furthermore, ptosis surgery will make the entire eyes larger.  It will increase the visibility of the inner iris (color aspect) and inner sclera (white aspect) of the eye.  Therefore, the entire inner aspect of the eyes are more open and the skin and soft tissue is cleared.
If one attempts to remove too much skin from the inner corner of the eyes, then you will expose the caruncle (pink aspect) of the inner eyes.  This will make one’s eyes look very unnatural and over-exposed.  This makes the person looking at the eyes feel uncomfortable as people have a psychological aversion to looking at overly exposed caruncle ( a pink aspect of the eyes).  Therefore, proper and comprehensive opening of the inner aspect of the eyes will give the most aesthetically pleasing eyes.
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