Cabn An Inner Eye Corner Z Plasty Turn it Downward?

Q: Dr. Eppley, Do youperform medial z plasty to make eye’s inner corner downturned and if how long it lasts. My concerns are mostly about my area being short and round and little bit feminine .I would want it to be more longer in palpebral fissure length term.I do think it will work in medial canthus in z plasty .but can orbital osteotomies or osteotomies in eye area increase palpebral fissure length such as tripod ,or combined procedures.or is it being performed 

A:An inner eye corner Z-plasty  is a permanent procedure which adds length as well as turns it downward.

Orbital osteotomies can increase palpebral fissure length primarily in the lateral or outer corner increase.

Dr. Barry Eppley

Plastic Surgeon