Comparison of Modified Asymmetric Inverse Z-plasty and Z-plasty in the Correction of Epicanthal Folds
Bibliographic record
Abstract
BACKGROUND: Epicanthoplasty is the most common cosmetic eye surgery. However, traditional surgical strategies usually cause visible scars in the medial canthus. This study innovatively aimed to propose a modified asymmetric inverse Z-plasty derived from the traditional Z-plasty technique to minimize postoperative scars and consequently enhance patient satisfaction. METHODS: This retrospective study included 172 patients with epicanthal folds who underwent an epicanthoplasty. Group A patients (n = 94) underwent modified asymmetric inverse Z-plasty, whereas Group B patients (n = 78) underwent Z-plasty. Postoperative outcomes, including scarring (assessed using the Vancouver scar scale [VSS]), scar hiding degree, patient satisfaction, and recurrence rates, were evaluated at 6 months. RESULTS: Postoperative evaluations revealed that both groups achieved normal wound healing without infections or complications after 7 days. VSS assessments indicated superior scar outcomes in Group A patients with moderate-to-severe epicanthal folds compared with those in Group B participants. Scar hiding degree analysis demonstrated a significantly higher percentage of postoperative pure hidden scars in Group A (P = 0.0042), particularly in moderate (P < 0.0001) and severe epicanthal folds (P = 0.002). Patient satisfaction was significantly higher in Group A (79.8%, very satisfied) than in Group B (47.4%, P < 0.0001). However, no significant difference in recurrence rates was observed between the two groups. CONCLUSION: Patients treated with modified asymmetric inverse Z-plasty exhibited superior scar hiding degree and overall satisfaction compared to those who underwent Z-plasty. Hence, modified asymmetric inverse Z-plasty is an effective treatment for patients with epicanthal folds, particularly in moderate-to-severe cases. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".