Objective To provide a comprehensive review of the surgical methods for repairing post-epicanthoplasty deformity, aiming to offer a reference for clinical decision-making in selecting appropriate techniques. Methods Relevant research literature concerning the repair of post-epicanthoplasty deformities was extensively reviewed. The background, clinical applications, and current challenges of these reconstructive procedures were summarized and analyzed. Results Post-epicanthoplasty deformities are not uncommon, and with evolving aesthetic standards, the demand for medial canthal reconstruction is increasing. The primary surgical techniques reported in the literature include the V-Y advancement flap, the reverse skin-redraping method, and the reverse Z-plasty. In recent years, the application of orbicularis oculi myocutaneous flaps has become more prevalent. While most of these procedures yield satisfactory outcomes, they still face certain limitations, particularly in addressing challenges related to scar management, individual patient variations, and the precise control of medial canthal morphology. Conclusion When clinically addressing post-epicanthoplasty deformities, surgeons must select the most suitable surgical method based on a comprehensive assessment of the patient’s specific condition and various contributing factors. An individualized approach is crucial to achieving the optimal aesthetic and functional outcomes.