Can Eye Reshaping Surgery Make These Changes Possible?
Q: Dr. Eppley, I have a few questions regarding eye reshaping procedures that I don’t think are talked about. I have always liked wide set, narrow, uptilted, “long” eyes that had an excessive horizontal span with minimal vertical height.
I have attached a photo highlighting some things.
1. Can the space between the eyes(interpupillary distance) be increased for cosmetic reasons?
2. Is there anyway to obliterate an epicanthal fold completely? Not just push it over slightly but actually turn an asian epicanthal fold to a completely caucasian eye with no epicanthal fold.
3. What surgery would raise the lower eyelid closer towards the medial? When I squint my lower eyelid, it brings up the medial lower eyelid. When I see photos of canthoplasties, it seems they elevate the corners of the eyes to create a severe cat-like look that is in the direction of vertical.
4. Relating to the top middle photo of my eyes, you can see a before and after of where I am putting a lateral horizontal vector on my eyes. Can this surgically be done with long lasting results? Again, with canthoplasties, they are done all the time as well as brow lifts but these are always either in a vertical pull or 45 degree angle pull. I’m simply looking for a horizontal pull to create an elongated look.
5. In the photos of the two women, they both have narrow, elongated, medial palpebral fissures but more importantly, the outside of their eyes are very long. There is a lot of white show to the lateral part of their irises, is there anyway to extend and create this for someone that does not have a lot of lateral eye exposure?
6. In the gentleman on the right, he also has a very elongated medial palpebral fissure, even more exagerrated than the two women. can this also be replicated on your average person?
Thank you for your time.
A: In answer to your eye reshaping questions:
1) THE INTERPUPILLARY DISTANCE CAN NOT BE SURGICALLY CHANGED. THAT IS A FUNCTION OF THE MEDIAL ORBITAL WALL BONES AND THE ATTACHMENTS OF THE MEDIAL CANTHAL TENDONS.
2) MEDIAL EPICANTHOPLASTY PARTIALLY OBLITERATES THE FOLD. IF THE L FLAP TECHNIQUE IS DONE TO THE MAXIMUM YOU CAN PROBABLY ELIMINATE IT COMPLETELY BUT AT THE PRICE OF POTENTIALLY ADVERSE AND VISIBLE SCARRING.
3) THERE IS NO SUCH SURGICAL PROCEDURE THAT CAN ACCOMPLISH THAT TYPE OF LOWER EYELID MOVEMENT.
4) THAT IS NOT A CANTHOPLASTY PROCEDURE BUT A CANTHOPEXY PROCEDURE. THAT CAN PULL THE CORNER OF THE OUTER EYE OUTWARD IN A COMPLETELY HORIZONTAL DIRECTION. THE QUESTION IS HOW DOES IT HOLD UP OVER TIME.
5) THE PROBLEM IS IF YOU PULL THE OUTER CORNER OF THE EYE OUTWARD IT WILL LIKELY CREATE A SEPARATION OF THE LATERAL LID MARGIN FROM THE EYEBALL, CREATING A SETUP FOR EXCESSIVE TEARING AND/OR DRY EYES.
6) NO THE MEDIAL PAPLPEBRAL FISSURE CAN NOT BE ELONGATED.
Dr. Barry Eppley