Comparison of asymmetric Z-plasty and Stallard Z-plasty in correction of epicanthus

J Cosmet Dermatol. 2024 Apr;23(4):1331-1337. doi: 10.1111/jocd.16114. Epub 2023 Dec 26.

Abstract

Objective: To investigate the clinical effect of asymmetric Z-plasty with central axis inward displacement and stallard Z-plasty in the correction of epicanthus.

Methods: We retrospectively analyzed 193 patients who underwent epicanthal plasty in the Department of Plastic and Laser Cosmetology of Hunan Provincial People's Hospital from 2009 to 2019. The patients were divided into two groups according to different surgical methods: group A (n = 125) received the asymmetric Z-plasty with central axis inward displacement method and group B (n = 68) received the stallard Z-plasty method. The incidence of early postoperative complications, epicanthus retraction and scar concealment from 6 months after the operation were analyzed and evaluated.

Results: After 7 days postoperation, both group A and B of patients had grade A wound healing without any infection or poor wound healing. As for the retraction of the epicanthus, 97.6% of group A patients had no retraction and 2.7% had mild retraction, while 92.6% of group B patients had no retraction and 7.4% had mild retraction. The rank-sum test showed no statistically significant difference (p > 0.05) between the two groups. Regarding scar concealment, 35.2% of group A patients had partially hidden scars and 64.8% had completely hidden scars, while 72.1% of group B patients had no hidden scars and 27.9% had partially hidden scars, with a statistically significant difference (p < 0.05).

Conclusion: Compared with stallard Z-plasty, asymmetric Z-plasty with central axis inward displacement has the advantages of concealed incision, easier scar concealment, less scar hyperplasia and stable effect, which results in higher postoperative satisfaction.

Keywords: Epicanthal plasty; asymmetric Z‐plasty; efficacy comparison; scar; stallard Z‐plasty.

MeSH terms

  • Blepharoplasty* / methods
  • Cicatrix* / etiology
  • Cicatrix* / surgery
  • Eyelids / surgery
  • Humans
  • Retrospective Studies
  • Wound Healing