Today's topic.
A few notes on this case.
He was a male patient who had a medial epicanthoplasty (Asian medial canthal release) at another clinic and felt that too much of his caruncle was exposed afterward. He came in for a reversal.
Caruncle exposure was at 100 percent in front.
When I perform a medial epicanthoplasty I generally aim for around 70 to 80 percent caruncle exposure.
Why?
Two old lectures of mine cover the reasoning.
Excessive caruncle exposure can give the face a harsh, sharp expression.
I performed the reversal on this patient using the transposition flap technique I published in 2019.
See my paper.
The pre-op photo above shows the 100 percent caruncle exposure in front.
Immediately after surgery, the marked area where caruncle exposure needed to be reduced is now appropriately closed.
One week post-op. Suture marks still show and there is residual swelling, but the closure is holding well.
Longer follow-up will tell us more.
Another video — I am slowly getting the hang of editing.
The most important point?
Do not open it widely and then try to close it back down. Discuss carefully with the patient and always err on the side of opening less.