Epicanthoplasty in Korea — The Complete Guide to Inner, Outer & Lower Eye Corner Surgery, Recovery & Stay for International Patients

What Is Eye Corner Surgery — Inner, Outer & Lower Canthoplasty

Eye corner surgery gently opens the inner, outer or lower edge of the eye to adjust its width and height, the distance between the eyes and the angle of the outer corner. If double eyelid surgery creates the line, eye corner surgery changes the frame of the eye. That is why even a small change can alter your whole impression, and why it is hard to undo once opened — keep that in mind first.

What Changes Depending on Where It Is Opened

Depending on your eyes, only one of these may be done, or none may be needed at all.

Who It Suits / When to Be Careful

Good candidates

• You have an epicanthal fold covering much of the inner corner, so your eyes look small and closed-in
• The distance between your eyes is clearly wider than the width of one eye (inner corner surgery)
• You want an outline double eyelid, but the fold cuts the line off at the inner corner
• Your eyes are short in width, or the outer corners tilt up and look sharp (outer and lower canthoplasty)

When to be careful

• The distance between your eyes is already close, or about the same as the width of one eye — inner corner surgery can make the space between the brows look narrow and the eyes look crowded together
• A tendency toward keloid or hypertrophic scars
• A narrow bony space at the outer corner, or prominent eyes — outer canthoplasty has less effect and re-adhesion is more likely
• A drooping lower eyelid or a lot of white already showing — a risk of exposed lid lining with lower canthoplasty
• Severe dry eye, or taking blood-thinning medication

Inner Corner Surgery — The Epicanthal Fold and Eye Spacing

The epicanthal fold is a fold of upper eyelid skin that covers the inner corner of the eye, and it is common in East Asians. Inner corner surgery opens part of this fold so the small pink area (the lacrimal caruncle) shows a little, and reduces the distance between the eyes. The incision method (Z-plasty, skin redraping, etc.) is chosen by the doctor based on scar placement and how much needs to be opened.

• How much the fold is opened is the key — if too much of the caruncle shows, the eye looks red and sharp
• Combined with an outline or in-out line double eyelid, the line connects naturally at the inner corner
• Reversal surgery is harder than the first operation, and a complete return to the original is not guaranteed

Outer & Lower Canthoplasty — Width and the Look of the Outer Corner

Outer canthoplasty makes the eye longer by making an incision at the outer corner. However, there are bone and ligaments outside the corner, so there is a limit to how much length can be added, and the effect can lessen if the healed wound re-adheres. That is why it is sometimes planned together with lower canthoplasty.

Lower canthoplasty lowers the outer line of the lower eyelid to soften the angle of the outer corner and increase the eye's height. If lowered too much, the lower eyelid can turn outward (ectropion), red lining may show and the eye may feel sore, so the tightness of the lower eyelid and how much the eye protrudes are always checked.

Combining with Double Eyelid or Ptosis Surgery

Doing them together means a single recovery, but swelling is greater and lasts longer, and the results affect each other.

Not every combination is necessary. Rather than adding eye corner surgery just because it makes the eyes look bigger, work out with your doctor first what you actually want to change about your eyes.

Surgery Day Flow & Anesthesia

1. 1
   In-person consultation — the distance between your eyes, eye width and outer corner angle are measured, and you decide which corner to open and by how much. A manager interprets, and you confirm that the consulting doctor performs the surgery personally.
2. 2
   Anesthesia — mostly local anesthesia; sleep anesthesia may be added if you are very nervous or having double eyelid or ptosis surgery at the same time.
3. 3
   Surgery — about 30 minutes to 1 hour for eye corner surgery alone, longer if combined with other surgery.
4. 4
   Going back — you rest after a cold compress and then head to your accommodation. If you had sleep anesthesia, your manager goes with you.

Recovery Timeline — Swelling, Bruising, Stitches & Scars

• Surgery day
  Swelling and stiffness; your eyes may water or your vision may be blurry. Keep your head raised and use a cold compress.
• Days 2–3
  Swelling and bruising are at their worst. The incision feels tight and looks red.
• Days 5–7
  Stitches out. Major swelling starts to go down, and sunglasses make going out easier.
• Weeks 2–3
  Most bruising is gone and you can go about daily life with light makeup.
• Months 1–3
  The scar may be red and a little firm. For outer canthoplasty, this is when we watch for re-adhesion.
• After months 3–6
  Redness fades, the scar softens and the shape settles. Depending on your constitution, it can take close to a year.

Sample Stay Plan — Based on 7–10 Days

Eye corner surgery alone or with double eyelid surgery (about 7 nights, 8 days)

• Day 1
  Arrive → consultation and design decisions
• Day 2
  Surgery → rest and cold compress at accommodation near the clinic
• Days 3–5
  Dressing and check-ups, mostly indoors
• Days 6–7
  After stitch removal, light outings with sunglasses
• Day 8
  Final check-up → fly home

Precautions While Traveling & After You Return

Remember these while traveling

• Use sunglasses, a hat and sunscreen to prevent scar pigmentation
• Don't rub your eyes or sleep face down; sleep with your head raised for 1 week
• Avoid saunas, jjimjilbang and swimming pools until the wound has healed
• The cabin air is dry, so bring artificial tears
• After you return home, follow the clinic's instructions for scar ointment and tape

Normal Symptoms, When to Contact Us, Overcorrection & Reversal

Symptoms that can be normal

• Swelling and bruising in the first 1–2 weeks, with differences between the left and right
• Scar redness, firmness and itching (fading over several months)
• More tears than usual or a dry feeling
• The inner corner looks overdone at first, then settles as swelling goes down

Contact your manager right away if

• Your vision suddenly blurs or you have severe eye pain
• Swelling on one side only increases sharply and the bruise grows
• Fever, pus or spreading severe redness appears
• The wound opens, or the lower eyelid looks turned outward (even after you return home)

Overcorrection, Re-adhesion & Epicanthoplasty Reversal

If inner corner surgery is overdone, too much of the caruncle shows and the eye looks red and sharp, and undoing this is called epicanthoplasty reversal. It is a surgery that redraws the skin to recreate part of the epicanthal fold, and a complete return to the original is difficult. With outer canthoplasty, on the other hand, the corner can re-adhere and the effect can lessen, so some people consider revision surgery. In either case, the decision is generally made after 6 months, when the scar has matured.

10 Questions to Ask at Your Consultation

When you come from overseas you may only get one or two chances to consult. Write down the questions below and bring them. Your manager will organize them in advance and interpret for you.

1. Given my eye spacing and eye width, which corner surgery do I need, and why?
2. Can you show me with a mirror or photos how much of the epicanthal fold you plan to open?
3. What incision method will you use, and where will the scar be?
4. How likely is re-adhesion with outer canthoplasty, and how is it prevented?
5. Will the doctor who consults with me perform the surgery personally?
6. When are the stitches removed, and when can I fly home?
7. When and how should I start scar care (ointment, tape, laser)?
8. Can I get a record of my surgery (incision method and extent)?
9. What are the criteria for revision if there is overcorrection or re-adhesion, and who bears the cost?
10. After I return home, can you review my progress from photos?

How to Choose a Clinic

• A board-certified specialist with plenty of eye surgery experience consults with you and operates personally — the doctor who consults is the doctor who performs the surgery
• They don't push eye corner surgery automatically, and will tell you so if your eyes don't need it
• They explain the amount of inner corner opening and the scar location in concrete terms
• They have experience with revision and epicanthoplasty reversal, so they can respond if a problem arises
• A monitoring system for sleep anesthesia, and whether you can request CCTV recording of the operating room
• Foreign-language support, and follow-up of your progress from photos after you return home

KBEAU connects you with partner clinics in Gangnam and Apgujeong led by board-certified plastic surgeons. Send front-facing photos and photos with your eyes closed, and we will tell you in advance whether eye corner surgery is needed, which combinations are possible and how many days you need to stay. A dedicated manager accompanies you through consultation, surgery and stitch removal and interprets for you, and we can also arrange a recovery stay near the clinic and an airport pickup car.