What is Anterior Canthoplasty Side Effects and Iatrogenic Mongolian Fold?
When a scar settles along the anterior canthoplasty incision line and appears like an original Mongolian fold, this phenomenon is called an iatrogenic Mongolian fold, and it is known as one of the representative side effects that can appear after anterior canthoplasty.
Anterior canthoplasty is a surgery that incises the medial canthus area to make the eyes appear longer and more open. During the process of the incision healing, if scar tissue contracts, new traces of Mongolian fold-like appearance may develop that did not exist before surgery, or existing Mongolian folds may become more prominent. It is reported that depending on the shape of the scar tissue, if it remains in a round shape, it appears as an iatrogenic Mongolian fold, and if it remains in a vertical line form, it tends to appear as a so-called medial canthus "ㄷ-shaped deformity."
Clinically, cases requiring re-consultation due to scar-related discomfort after anterior canthoplasty are reported in approximately 5-10% of all procedures, and the frequency of occurrence can vary depending on individual skin elasticity and incision design.
Characteristics of Medial Canthus Shape Deformity and Lacrimal Lake Exposure Asymmetry
When iatrogenic Mongolian fold is accompanied by the medial canthus clumping in a round shape or left-right symmetry becoming misaligned, the appearance can look unnatural.
A normal medial canthus generally forms a pointed shape (V-shaped), and if this form breaks down, it can give an stuffy or surgically done appearance. When accompanied by asymmetry where the degree of exposure of the left and right lacrimal lake (the area where tears gather) differs from each other, the eye shape may appear fierce on only one side or look awkward.
It is observed that even a subtle difference of around 1-2mm in left-right medial canthus asymmetry can be distinctly recognized to the naked eye.
Treatment Principles and Recovery Process of Anterior Canthoplasty Restoration (Anterior Canthoplasty Reconstruction)
Anterior canthoplasty restoration (anterior canthoplasty reconstruction) is a corrective treatment aimed at repositioning the existing incision scar and deformed tissue to regain a natural medial canthus shape.
Anterior canthoplasty restoration is described as a procedure that organizes the scar tissue of the existing incision line and repositions the deformed medial canthus tissue to restore it closer to the original pointed medial canthus shape. Suture removal after surgery typically occurs around 7 days post-op, and from this point on, swelling and scars often gradually fade. However, it is necessary to note that immediately after surgery, the tissue may appear temporarily sharp during the settlement process, and subsequently over approximately 6-12 months, the tissue may stabilize and the shape may change gradually.
It is reported that approximately 6-12 months is required for tissue to stabilize after anterior canthoplasty restoration, depending on individual variation.
Comparison of Treatment Methods: Incision Repositioning and Local Scar Correction
Depending on the degree of iatrogenic Mongolian fold and medial canthus deformity, we can examine reconstruction approaches through incision repositioning and localized scar correction approaches.
The approach may vary depending on the degree and range of deformity, and below are the general characteristics of the two treatment methods.
| Classification | Incision Repositioning (Anterior Canthoplasty Restoration) | Local Scar Correction |
|---|---|---|
| Target Application | Cases with prominent iatrogenic Mongolian fold, pronounced left-right asymmetry | Cases with only mild scar marks remaining |
| Recovery Period | Swelling resolution approximately 2-4 weeks, tissue stabilization approximately 6-12 months | Approximately 1-2 weeks |
| Recurrence Possibility | Individual variation exists and additional correction may be necessary | Scar recurrence possibility is low but may have limitations in improving fundamental deformity |
| Cost Range | Mid to high range (non-covered item varies by hospital) | Mid to low range (non-covered item varies by hospital) |
Both approaches are not absolutely superior methods, and the appropriate treatment method can vary depending on the degree of deformity and individual tissue condition.
Matters to Confirm During Consultation and Consultation Approach
Sheone Plastic surgery (plastic surgery specializing in eye surgery and eye revision surgery) conducts consultations through 1:1 pre-operative consultations to analyze eye condition and then guides treatment plans tailored to individual characteristics.
When considering anterior canthoplasty restoration, a comprehensive review process of existing scar shape, degree of left-right asymmetry, and previous surgical history is necessary. During consultation, typically a precision diagnostic process of around 30 minutes is conducted to understand eye condition, and based on this, the reconstruction range and method are individually adjusted. Sheone Plastic surgery is guided to have focused clinical practice areas in canthoplasty reconstruction (anterior canthoplasty restoration and posterior canthoplasty restoration) and canthoplasty surgery in the field of eye surgery and eye revision surgery, accumulating rich clinical experience.
Precision diagnostic consultation typically proceeds for around 30 minutes, during which individual tissue condition and degree of deformity are confirmed.
Frequently Asked Questions (FAQ)
When does anterior canthoplasty side effects recover?
Initial symptoms such as swelling and erythema tend to be alleviated within approximately 2-4 weeks, but complete stabilization of scar tissue can take approximately 6-12 months. Recovery speed may vary depending on individual skin elasticity and management condition.
Does iatrogenic Mongolian fold disappear on its own over time?
In mild cases, some improvement is reported over time, but when scar tissue contraction has already progressed, it is known that professional medical consultation for correction is often necessary rather than complete natural disappearance.
I'm concerned about scar tendency tissue—is anterior canthoplasty restoration possible?
Even with scar-prone tendencies, it is possible to approach by first conducting a precision evaluation of individual skin condition and scar formation tendency, then adjusting the incision range and method. However, depending on scar-prone tendencies, recovery progress and results may vary individually, so individual evaluation through consultation is important.
When is the appropriate time to have anterior canthoplasty restoration surgery?
Generally, it is common to consider reconstruction after the tissue has stabilized to some extent following the initial anterior canthoplasty, and the precise timing can vary depending on scar condition and degree of deformity, so it is advisable to make a judgment through individual consultation.
Can scars or deformity develop again after reconstruction surgery?
It is reported that even after reconstruction surgery, depending on individual constitution or management condition, the possibility of mild scar reformation or subtle shape changes may exist. For this reason, post-operative observation and regular follow-up are recommended.
It is recommended to confirm the treatment plan suitable for your eye condition through consultation.
Treatment results may vary depending on individual health condition, so please be sure to consult with a specialist.