Table of contents

• Medical Solutions for Eye Reshaping: Canthoplasty Procedures
• Best Clinics in Korea
• Pursuing Eye Reshaping Procedures in South Korea
• Patient Experiences and Outcomes: Addressing "Sanpaku Eyes"
• Conclusion
• References

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The term "Sanpaku gan" (三白眼), or simply "Sanpaku", is a Japanese phrase meaning "three whites." In English, it refers to an eye appearance where the white part of the eye, the sclera, is visible between the iris and either the lower or upper eyelid. The focus here is on the white visible below the iris, known as "Yin Sanpaku."

Common Pseudonyms and Cultural Beliefs

There are two main types of Sanpaku eyes:

• Yin Sanpaku: White sclera visible beneath the iris
• Yang Sanpaku: White sclera visible above the iris

Historically, these eye traits have been linked to physical and spiritual imbalances. Superstitions suggest that people with Yin Sanpaku face tragic fates, illness, or early death, with famous examples like Princess Diana, John F. Kennedy, Abraham Lincoln, and Marilyn Monroe often cited. Yang Sanpaku, on the other hand, is associated with violent tendencies, with cult leader Charles Manson as a notorious example.

These beliefs gained popularity in the West during the 1960s, largely due to George Ohsawa’s book You Are All Sanpaku, which used the concept to promote the macrobiotic diet. Importantly, there is no scientific evidence supporting these superstitions. The tragic outcomes linked to Sanpaku eyes are coincidental, and the so-called "curse" holds no real power beyond personal belief.

Medical Perspective: Distinguishing Appearance from Underlying Conditions

While "sanpaku eyes" is steeped in cultural meaning, the visible white below the iris is a real anatomical feature. Medically, this is called scleral show or may indicate eyelid retraction. Unlike the mystical interpretations, this is an anatomical variation or symptom of an underlying condition.

Eyelid retraction occurs when the eyelid is abnormally positioned—either raised or lowered—exposing the sclera between the eyelid margin and cornea. Causes include congenital issues, thyroid eye disease, trauma, prior surgeries, or aging.

Beyond appearance, untreated eyelid retraction can cause discomfort and functional problems such as incomplete eye closure, dry eyes, redness, burning, irritation, tearing, and in severe cases, corneal ulcers. Surgical correction not only improves cosmetic concerns but also helps prevent these complications by restoring proper eyelid position.

Type	Description	Associated Cultural Beliefs	Notable Historical Examples	Scientific Validity
Yin Sanpaku	White visible below iris	Tragic fate, illness, early death	Princess Diana, JFK, Marilyn Monroe, Abraham Lincoln	No scientific evidence supports these beliefs.
Yang Sanpaku	White visible above iris	Violence, perpetrator	Charles Manson	No scientific evidence supports these beliefs.

Medical Solutions for Eye Reshaping: Canthoplasty Procedures

For those concerned about the appearance of Sanpaku eyes or eyelid function, canthoplasty procedures offer effective surgical solutions. These surgeries reshape the eye, reduce visible scleral show, and create a more balanced, aesthetically pleasing eye contour.

Canthoplasty: Traditional Surgical Approach

Canthoplasty is a reconstructive cosmetic surgery that reshapes the canthus, the corner where the upper and lower eyelids meet. It tightens muscles, tendons, ligaments, and connective tissues to correct droopy or sagging eyelids, unevenness, and eye shape. Also called inferior retinacular suspension or the almond eye procedure, it can create a refined, almond-shaped eye.

This surgery addresses cosmetic concerns like visible white below the iris and medically treats eyelid dysfunctions such as corneal damage (keratopathy), ectropion, entropion, lagophthalmos, or trauma.

Key types of canthoplasty include:

• Lateral Canthoplasty: Focuses on the outer eye corner, lifting and tightening the lateral canthus to elongate the eye and reduce scleral show below the iris.
• Hotz Canthoplasty (Lower Canthoplasty / Bottom Opening): Popular in Korea, this increases vertical width at the outer eye corner and aligns the pupil with the lower eyelid using "fascial fixation" to soft tissue, producing a natural look without awkwardness.
• Epicanthoplasty: Targets the inner canthus and epicanthic fold, often combined with other surgeries to enhance eye openness, especially in Asian patients.

Related procedures:

• Canthopexy: A less invasive tightening of the canthal tendon without detachment, suitable for mild cases.
• Blepharoplasty: Removes excess skin, muscle, and fat from eyelids, often combined with canthoplasty for full rejuvenation.

The Surgical Process: Step-by-Step

1. Pre-operative Preparation: Includes lab tests, medication adjustments, quitting smoking, and switching to glasses from contacts.
2. Anesthesia: General anesthesia (sleep) or local anesthesia (numbing), sometimes with sedation.
3. Incision: Small incisions near the eyelid, often 5-7 mm lateral to the eye corner, minimizing visible scars.
4. Tissue Adjustment: Tightening and repositioning the eyelid tendon and muscles. Traditional canthoplasty detaches and shortens the lateral canthal tendon, reattaching it to the orbital rim. Hotz canthoplasty fixes tissue to soft tissue (capsulopalpebral fascia).
5. Suturing: Fine stitches close the incision.
6. Duration: Typically 30 minutes to 3 hours, depending on complexity.

Recovery and Potential Considerations

Post-surgery, patients usually feel no pain due to anesthesia but may experience mild discomfort, swelling, and bruising for 1-2 weeks. Swelling peaks around 48 hours and then subsides. Protective eye pads are worn for 24-48 hours. Stitches are removed around day 5-7. Makeup and light activities can resume after 7-10 days, but rubbing eyes, heavy exercise, and sun exposure should be avoided initially.

Wound care involves cleaning with sterile water and applying antibiotic ointment three times daily for two weeks. Keeping the head elevated helps reduce swelling. Full recovery takes 2-4 weeks, with final results visible after 2-3 months as residual swelling fades.

Risks include bleeding, infection, overcorrection, undercorrection, and very rarely, eye or vision damage. Choosing an experienced surgeon is crucial to minimize complications and achieve natural results.

Laser Canthoplasty: Precision and Innovation

Laser Canthoplasty is a modern advancement using laser technology to reshape the eye corners with high precision. Popular in Korea, it helps achieve youthful, open, almond-shaped eyes.

Advantages over traditional surgery include:

• Precision: Laser creates exact incisions at precise angles and depths.
• Reduced Bleeding and Inflammation: Laser cauterizes while cutting, minimizing tissue damage.
• Minimal Scarring: Laser incisions heal with less visible marks.
• Quicker Healing: Less trauma leads to faster recovery.

The Laser Surgical Process: Step-by-Step

1. Anesthesia: Usually local anesthesia in an outpatient setting.
2. Laser Incisions: Precise cuts made at the lateral canthus with a laser device.
3. Reshaping: Adjusting the lateral canthal tendon to achieve desired eye shape without extensive tissue removal.
4. Suturing: Fine stitches close the incisions.
5. Duration: Typically 30 minutes to 1 hour, up to 2 hours for complex cases.

Recovery and Benefits

Post-op care includes cold compresses and following surgeon instructions. Recovery is faster than traditional surgery, with most patients resuming normal activities within a week. Laser Canthoplasty offers less bleeding, swelling, scarring, and a more comfortable healing process.

Feature	Canthoplasty (Traditional)	Laser Canthoplasty
Technique	Scalpel-based	Laser-based
Incision Method	More invasive	Precise laser incisions
Bleeding During Surgery	Higher	Reduced
Swelling & Bruising	More pronounced	Minimal
Scarring Potential	Potentially more visible	Minimal
Recovery Time (Initial)	5-7 days	Often within a week
Recovery Time (Full)	2-4 weeks	Quicker (within a week routine, 2-3 months final)
Precision	Good	Excellent
Suitability for "Sanpaku Eyes"	Yes (tightening/repositioning)	Yes (precise reshaping/adjustment)

Best Clinics in Korea

Listed below are the best clinics in Korea:

Clinic Name	Key Features	Special Techniques
THEPLUS Plastic Surgery	Renowned for facial procedures, led by distinguished surgeons	Innovative research on 3D implants, harmonious balance of facial features
Made Young Plastic Surgery	Premier destination for sanpaku-eyes-korea procedures, blend of traditional beauty and state-of-the-art techniques	Personalized treatment plans, non-invasive lifting
Okay Plastic Surgery Clinic	Transformative approach to aesthetic care, specialized professionals	Eye plastic surgery, double eyelid and eye correction, ectopic surgery

THEPLUS Plastic Surgery

THE PLUS Plastic Surgery clinic, located in the vibrant Garosu-gil area of Gangnam, Seoul, is renowned for its exceptional expertise in cosmetic surgery, particularly in the realm of facial procedures. The clinic is led by distinguished surgeons such as Dr. Kim Taek Kyun and Dr. Jeong Jae Yong, who are celebrated for their contributions to the field of rhinoplasty and facial contouring. Dr. Kim, a board-certified plastic surgeon, is recognized globally for his innovative research on 3D implants and his commitment to enhancing natural beauty through a harmonious balance of facial features. Dr. Jeong, the President of the Korean Society of Plastic Surgeons, is known for his unique approach that combines function and aesthetics, ensuring that each procedure not only enhances beauty but also maintains or improves functionality.

THE PLUS Plastic Surgery clinic offers a comprehensive range of services, from initial consultations to post-operative care, all within its state-of-the-art facility. The clinic's dedication to excellence is reflected in its surgeons' active participation in international medical symposiums and their contributions to academic research. This commitment ensures that they remain at the forefront of cosmetic surgery advancements, providing patients with cutting-edge procedures and personalized care. Whether it's rhinoplasty, facial contouring, or other cosmetic enhancements, THE PLUS Plastic Surgery clinic stands out as a leader in the industry, promising exceptional results and patient satisfaction through the expertise of its highly skilled surgeons.

You can check out their website here: THEPLUS Plastic Surgery Website

Made Young Plastic Surgery

Made Young Plastic Surgery Clinic, located in Seoul's renowned Gangnam district, is widely regarded as the premier destination for sanpaku-eyes-korea procedures in Korea. This esteemed clinic is celebrated for its exceptional blend of traditional beauty ideals and state-of-the-art techniques, ensuring that each patient receives the highest standard of care and safety. With a comprehensive array of services ranging from face lifts and contouring to non-invasive lifting and rhinoplasty, Made Young is equipped to address a variety of aesthetic concerns. The clinic's team of seasoned plastic surgeons and medical professionals are dedicated to crafting personalized treatment plans that not only enhance physical appearance but also boost the confidence and well-being of their patients. By prioritizing patient safety and satisfaction, Made Young Plastic Surgery Clinic stands out as a beacon of hope for those seeking transformative and rejuvenative procedures in Korea.

You can check out their website here: Made Young Plastic Surgery Website

Okay Plastic Surgery Clinic

At Okay Plastic Surgery Clinic, we are dedicated to providing a transformative approach to aesthetic care, particularly for those seeking solutions for sanpaku eyes in Korea. Our philosophy is centered around sincerity, precision, and individualized treatment, ensuring that each patient receives a tailored solution that aligns with their unique needs and aspirations. Our clinic is led by a team of specialized professionals, including a renowned female plastic surgeon with extensive experience, who guide patients through a comprehensive journey of personal transformation. This journey is supported by our expertise, empathy, and the use of cutting-edge medical techniques.

Our clinic offers a wide range of specialized aesthetic services designed to address diverse patient needs, including eye plastic surgery, which is crucial for those looking to enhance or correct the eye area. Our procedures include double eyelid and eye correction, ectopic surgery, under-eye treatments, and middle-aged eye surgery, all of which are tailored to meet the specific requirements of our patients. By focusing on precision and individualized care, Okay Plastic Surgery Clinic stands out as a leading destination for those seeking to address sanpaku eyes and other aesthetic concerns in Korea.

You can check out their website here: Okay Plastic Surgery Clinic Website

Pursuing Eye Reshaping Procedures in South Korea

South Korea is a global leader in cosmetic eye surgeries, attracting many international patients. Here’s what the process looks like and why Korea is a top choice.

The Patient Journey: Process for International Patients

1. Consultations: Often virtual or in-person (e.g., JK Plastic Surgery), surgeons discuss goals, assess eye shape, skin, and medical history to tailor the procedure.
2. Pre-operative Instructions: Fasting, no smoking, removing contacts and jewelry.
3. Anesthesia: Usually conscious sedation with local anesthesia for comfort.
4. Surgery Duration: Non-incisional methods take ~30 minutes; complex surgeries up to an hour. Lateral Canthoplasty takes 30-60 minutes; Laser Canthoplasty 30 minutes to 2 hours.
5. Post-operative Care: Cold compresses, head elevation, protective eye patch for 24-48 hours. Stitches removed around day 5-7. Avoid rubbing eyes, makeup, sun exposure, heavy exercise initially.
6. Support: Clinics provide 1:1 management, tissue regeneration treatments, follow-ups, medications, and skincare guidance.
7. Full Recovery: Initial healing in 1 week; final results in 2-4 weeks with refinement over 2-3 months.

Why South Korea? Unparalleled Benefits for Eye Surgery

South Korea offers a seamless medical tourism experience with:

• World-Class Expertise: Highly skilled surgeons with advanced training, personalized procedures, and cultural understanding of aesthetics, especially for East Asian features.
• Advanced Technology & Infrastructure: State-of-the-art facilities, high medical standards, and efficient surgical systems.
• Affordability & Competitive Pricing: Procedures cost $1000-$3500 USD, much less than $4000-$8000 USD in the USA, often including comprehensive packages covering surgery, aftercare, accommodation, and translation.
• Enhanced Patient Experience: Meticulous post-op care, quick recovery, high satisfaction, and robust support for international patients.

Category	Specific Benefits
Expertise	World-Class Surgeons, Customized Procedures, Cultural Understanding of Aesthetics
Technology & Infrastructure	State-of-the-Art Facilities, High Medical Standards, Efficiency & Precision
Affordability	Competitive Pricing ($1000-$3500 USD), Comprehensive Packages
Patient Experience	Comprehensive Post-Operative Care, Quick Recovery, High Satisfaction, Medical Tourism Support

Patient Experiences and Outcomes: Addressing "Sanpaku Eyes"

Canthoplasty directly targets the visible white sclera below the iris, offering both aesthetic and psychological benefits.

How Canthoplasty Addresses the "Sanpaku" Appearance

Procedures like Lateral Canthoplasty and Hotz Canthoplasty adjust the lower eyelid and outer eye corner to reduce scleral show, creating balanced, natural-looking eyes. Surgeons carefully evaluate scleral exposure, eyelid crease, and pupil size to ensure harmony with facial features.

Techniques such as "fascial fixation" in Hotz Canthoplasty and "periosteum fixation" in Lateral Canthoplasty help achieve strong, natural openings without exposing mucous membranes or causing eyelash problems. The goal is a subtle, undetectable enhancement that avoids an unnatural look.

Reported Patient Outcomes and Benefits

Patients often report eyes that look bigger, clearer, and more refreshed, with a more elongated almond shape. Combining Hotz and Lateral Canthoplasty (Dual Canthoplasty) maximizes eye opening and facial balance.

Minimal swelling and scarring contribute to natural results, with many patients returning to daily life quickly, sometimes the next day. Psychological benefits include boosted self-confidence, feeling refreshed, and improved self-esteem. Many patients feel comfortable without makeup and report a significant positive impact on their quality of life.

Important Considerations for Patients

Realistic expectations and understanding recovery timelines are essential. Choosing an experienced surgeon with a strong track record in eye contour surgery is critical to ensure safety, effectiveness, and natural results, minimizing risks like overcorrection or unnatural appearance.

Conclusion

While "sanpaku eyes" stem from superstition, the visible white below the iris is a real anatomical concern that can be effectively treated. Canthoplasty and Laser Canthoplasty offer precise surgical solutions to reduce scleral show, improve eye aesthetics, and relieve discomfort like dry eyes. South Korea leads globally in these procedures, combining expert surgeons, advanced technology, competitive pricing, and excellent patient care. Patients often experience not only enhanced eye appearance but also significant boosts in confidence and well-being. Choosing a qualified surgeon and making informed decisions are key to achieving safe, natural, and satisfying results.

References

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