Minimizing Postoperative Scars in Epicanthoplasty: A Concise Review.

[BACKGROUND] The epicanthal fold is a fibromuscular skin fold covering the medial aspect of the eye. Upper double eyelid blepharoplasty and epicanthoplasty have become the most frequently performed cosmetic surgeries in Asia. However, many surgeons have expressed concern for hypertrophic scarring following epicanthoplasty. Therefore, exploring scar-minimizing techniques should interest surgeons performing epicanthoplasty, especially since most candidates for this type of surgery are more susceptible to hypertrophic scarring due to genetic factors.

[OBJECTIVES] This review aims to contribute to reducing post-epicanthoplasty scarring by presenting a synopsis of the existing medical literature on scar-minimizing strategies for medial epicanthoplasty.

[METHODS] PubMed and EMBASE searches were conducted on October 25, 2025, and following screening, 85 publications were included.

[RESULTS] As novel techniques have increasingly focused on tension release within the epicanthal fold, most procedures are now well-tolerated with a low recurrence rate and a high degree of patient satisfaction.

[CONCLUSIONS] While numerous techniques have been described, no single method suits all cases. Based on trends in the literature, the skin redraping technique appears to be a versatile option with limited scarring in diverse scenarios, though this inference is not supported by randomized or prospective comparative data. Prospective, randomized studies are needed to compare the efficacy and cosmetic outcomes of different approaches for different degrees of epicanthal folds.