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Section: Anatomy

The Epicanthal Fold

The epicanthal fold is a small web of tissue overlapping the nasal corner of the eye. It is seen in both Asian and Occidental eyelids, but is much more common and distinctive in Asian eyelids, where it seems to be present to at least some degree in almost every patient.

The fold may vary from hardly-noticeable to well-developed. It is typically most prominent during childhood, but often changes shape and diminishes in size with age as the developing bridge of the nose gains more height and pulls the skin away from the eye.

The reason for the increased prevalence and prominence of the epicanthal fold on the Asian eyelid has not been thoroughly elucidated, but undoubtedly the explanation lies in the many variations of the complex anatomy of the multi-contoured area of skin, muscle, and tendon located between the bridge of the nose and the inner corner of the eye.

The Epicanthal Fold

epicanthal fold
epicanthal fold
Minimal

Minimal

epicanthal fold
epicanthal fold
Moderate

Prominent

epicanthal fold
epicanthal fold
Occidental Child Mixed Heritage

Terminology used to describe the anatomic variations in the epicanthal folds is confusing and of limited clinical relevance. It is more helpful to speak of the fold as minimal, moderate, or prominent.

Epicanthoplasty is occasionally undertaken to soften the appearance of an especially prominent fold. Available procedures are not without risk and are best reserved for folds with substantial cosmetic impact.


Next: Stabilization of a Variable Crease


More
from this section: Anatomy >

Eyelid Features
Eyelid Anatomy
The Eyelid Crease
The Epicanthal Fold

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Frank Meronk, Jr., M.D.
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Note: Information, observations, and opinions are offered for general reference only and should not be taken as medical advice or diagnosis.

The Asian Epicanthal Fold