Among various side effects that can appear after epicanthoplasty surgery, "iatrogenic Mongolian fold" is a case relatively commonly observed in clinical practice. In this article, we will examine the causes and various forms of iatrogenic Mongolian fold, as well as treatment directions that can be considered for improvement.
What is Iatrogenic Mongolian Fold?
Iatrogenic Mongolian fold is a phenomenon that appears when the epicanthoplasty incision line remains as a linear scar, referring to a side effect occurring as a result of surgical intervention.
The term "iatrogenic" carries the meaning "occurring as a result of medical treatment" and is used to refer to secondary changes that appear during treatment or surgical procedures. In epicanthoplasty surgery, iatrogenic Mongolian fold appears as a scar at the incision site remaining in a linear form, making it appear as if it had existed originally or making an existing Mongolian fold more prominent.
Generally, it is known that a minimum observation period of 6 months to 1 year is required for scar tissue to stabilize to a certain degree after surgery.
During this period, it is desirable to sufficiently observe the form of the scar and whether Mongolian fold develops, and then judge the need for improvement and treatment direction.
Various Forms of Iatrogenic Mongolian Fold
Iatrogenic Mongolian fold is broadly divided into three forms and can appear overlapping with existing Mongolian folds or develop as new scar forms.
Iatrogenic Mongolian fold clinically observed is divided into the following three aspects:
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Cases where an existing Mongolian fold overlaps with the scar and appears more clearly
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Cases where a new Mongolian fold is newly formed that did not exist originally
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Cases where a step-shaped scar with a height difference of about 1-2mm is generated in the Mongolian fold area, or a depressed scar (Mongolian pouf) behind the Mongolian fold is accompanied
The third type, Mongolian pouf, sometimes develops in a state where an existing Mongolian fold remains, and sometimes appears in conjunction with iatrogenic Mongolian fold. Such scar patterns can appear differently depending on the incision method and individual skin and tissue characteristics.
Improvement Direction Through Scar Revision and Epicanthoplasty Reconstruction
Scar revision is a basic premise for improving iatrogenic Mongolian fold, and epicanthoplasty reconstruction may be needed together depending on accompanying problems.
Since iatrogenic Mongolian fold appears due to incision line scars, scar revision must be performed as a basic prerequisite to improve it. However, when complex problems such as Mongolian pouf or step-shaped scars are involved, scar removal alone makes it difficult to expect sufficient improvement, so epicanthoplasty reconstruction surgery is often performed together.
General differences between the two approaches
| Classification | Scar Revision Alone | Scar Revision + Epicanthoplasty Reconstruction Combined |
|---|---|---|
| Main Purpose | Scar tissue improvement | Simultaneous scar improvement and eye line reconstruction |
| Suitable Candidates | Cases with only simple linear scars | Cases with accompanying complex problems such as Mongolian pouf and step-shaped scars |
| Recovery Period (Range) | Approximately 2-4 weeks | Approximately 4-8 weeks |
| Timing of Revision Surgery Decision | After scar stabilization (after several months) | After comprehensive evaluation of scar and tissue condition |
The treatment direction can be designed differently for each individual by comprehensively considering scar form, tissue condition, existing surgical history, and others.
Considerations for Epicanthoplasty Reconstruction Surgery
Epicanthoplasty reconstruction accompanying iatrogenic Mongolian fold places more importance on individual customized judgment than standardized surgical methods, and the surgeon's clinical experience can affect results.
Complex problems that appear together with iatrogenic Mongolian fold are often difficult to resolve with one fixed surgical method. Since incision design and technique must be adjusted according to scar location, direction, and degree of tissue adhesion, immediate judgment and precise technique during surgery are required.
Sheone Plastic surgery (plastic surgery specialized in eye revision) establishes individual surgical plans suited to each patient's condition for cases where scars and Mongolian folds appear in combination, based on clinical experience in eyelid revision surgery fields such as epicanthoplasty reconstruction and reconstruction, epicanthoplasty reconstruction, double eyelid revision, and eye line correction. However, surgical results may vary depending on individual tissue characteristics and recovery progress, and a minimum of 6 months or more of follow-up observation may be necessary to confirm final results.
If you are considering epicanthoplasty reconstruction, it is desirable to receive an accurate diagnosis of the scar condition and Mongolian fold pattern, and then confirm a treatment plan suitable for you through consultation.
Frequently Asked Questions (FAQ)
Does iatrogenic Mongolian fold disappear on its own over time?
As scar tissue stabilizes to a certain degree, it may appear more improved than initially, but the incision line scar itself does not completely disappear and may persist depending on its form. It is generally recommended to observe the scar and Mongolian fold condition for at least 6 months or more before determining whether improvement has occurred.
Can epicanthoplasty reconstruction be performed if there is Mongolian pouf?
Mongolian pouf is a complex form accompanied by depressed scars behind the Mongolian fold, and scar revision is often performed together with epicanthoplasty reconstruction. However, the surgical method and approach may differ depending on the depth and extent of the scar and the degree of tissue adhesion, so precise diagnosis must be conducted first.
When can revision surgery be performed?
Generally, it is known that approximately 6 months to 1 year is needed for scar tissue from a previous surgical site to stabilize. After this period has sufficiently elapsed, it is recommended to re-evaluate the scar and Mongolian fold condition and determine the timing for revision surgery.
Can reconstruction surgery be performed if I have weak or sensitive skin?
Since skin and scar tissue conditions vary greatly from individual to individual, reconstruction surgery can be performed by adjusting appropriate surgical range and method through precise diagnosis, even for sensitive skin. However, there may be differences in recovery period and results depending on tissue condition, so confirmation through prior consultation is necessary.
Is there a difference between epicanthoplasty reconstruction and general epicanthoplasty surgery?
General epicanthoplasty surgery is the first surgery to improve Mongolian fold, whereas epicanthoplasty reconstruction is a revision surgery concept that corrects scar or Mongolian fold-related problems resulting from a previous surgery. Surgical difficulty and method can vary depending on scar condition and accompanying problems.
Treatment results may vary depending on individual health conditions, so please be sure to consult with a specialist.