The medial canthus is a webbed skin fold located at the inner canthus and is one of the characteristics of the oriental eye. It is found in about 50% of the Asian population and over 70% of the single-lid population. It obscures the normal shape of the medial canthus, resulting in a smaller medial canthus, shorter eye fissure, and wider medial canthal spacing, which hinders the aesthetic appearance of the eye. Many improved canthal restoration procedures have been reported, such as Z-plasty, W-plasty, Y-V-plasty, transverse incision and longitudinal suturing, and many others. However, there is not yet an accepted ideal method. For a long time, both the surgeon and the patient have been cautious about surgery because of the scar growth in the medial canthus and the poorly shaped medial canthus. The goal of many surgeons is to find a procedure that eliminates the medial canthus while making the scar less visible. The formation of the medial canthus was previously thought to be due to a horizontal excess of skin in the medial canthus and a vertical deficit; recent anatomic studies have further revealed that it is mainly due to the misalignment of the orbicularis oculi muscle at the beginning of the medial canthal ligament, which travels within the medial canthal fold along with the superficial fibers of the medial canthal ligament that are structurally abnormal. Some foreign scholars believe that the formation of canthal redundancy is related to the hypertrophy of the orbicularis oculi and fibrofatty tissue under the redundant skin, and the abnormal tension of the orbicularis oculi on the skin. Based on the above causes of canthus, our treatment principle is to relieve the longitudinal tension of the inner canthus, fully release the subcutaneous adhesions, trim the misshapen orbicularis muscle and inner canthal ligament, remove the thickened subcutaneous fascial tissue, and close the incision under tension-free sutures to reduce scar formation. Most of the problems with the previous surgical approach were: 1) the surgical incision was designed on the skin surface; 2) the flap design was complicated, with too many incisions and large tissue trauma; 3) the direction of the incision was not consistent with the direction of the skin pattern; 4) the misshapen orbicularis muscle and medial canthal ligament were not sufficiently released or removed; 5) the “excess” skin of the medial canthus was not properly treated. In order to avoid removing the excess skin when trimming the cat’s ear and to make the extended incision follow the direction of the lower eyelid Lang’s line or the skin line as much as possible, we extended the incision 2 mm below the free edge of the lower eyelid to reduce the tension of the skin after suturing and to reduce This is to reduce the tension of the skin after suturing and to reduce scarring. Features of this method: The medial canthus is mainly excess in the horizontal direction and deficient in the vertical direction from the skin, and the direction of tension generation should be mainly in the vertical direction. By making a horizontal one-line incision, the V-shaped advancement of the original medial canthal tissue flap fills the deficiency of the vertically oriented skin tissue. The tension of the vertically oriented skin was relieved. The decortication of the flap below the incision allows for rationalized retraction in response to tension, releases the adhesions of the skin to the heterotopic misshapen orbicularis oculi, the superficial head of the medial canthal ligament and the subcutaneous fascial tissue, and forms a reasonable new anatomical relationship between the skin and the subcutaneous tissue, minimizing skin surface tension after the incision is sutured. The “one-shape” incision that extends along the lower lid margin after the transverse incision of the redundant skin conforms to the distribution of the periapical Lang’s line and minimizes skin tension after suturing, which is one of the reasons for the concealed postoperative scar. The horizontal one-line incision of the medial canthus disconnects the medial canthal incision from the blepharoplasty line, reducing the effect of postoperative scarring on the medial canthal stress line, another reason why postoperative scarring is less likely to occur. The canthal ligament is partially severed at the anterior foot of the medial canthus, which allows the canthus to be lifted, and the medial canthal ligament is fixed to the lateral nasal tendon membrane, which also reduces skin tension in the horizontal direction from a deep level. A transverse one-line incision is used to detach the skin in a decorticate fashion, allowing the receding flab to be extended. Minimal skin tension is maintained during suturing without cutting the “excess” skin in the medial canthus. The disadvantage of this method is that there may be small folds of skin above the medial canthus for a short period of time after surgery, which are usually gradually adjusted and restored after 1 month.