How Can Canthoplasty Result Be Corrected?

A canthoplasty procedure was performed during my lower lid blepharoplasty and it has never felt or looked right. The blepharoplaty incision was made below the lashline, in a fold, and then curved sharply upward and joined to the canthoplasty incision.

That area now looks distorted and, oddly, the skin from my outer brow is pulling to the eye's corner in a visible line.

One surgeon has suggested laser to tighten, but I don't see how this can correct the poor tissue arrangement. Are there other ways to best correct this?

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7 Doctor Answers | Asked by SaraFina

Doctor Answers (7)
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Laser will not correct canthoplasty deformity

Laser resurfacing will tighten the skin which is the opposite of what you want. You need to have the canthoplasty revised and released to drop the corner of the eye and lessen the fold of the upper eyelid and brow area. This is a complex and delicate surgery, and requires an experienced board certified plastic surgeon who specializes in eyelid surgery. Hopefully, partial release of the canthoplasty and revsion of the scar will suffice. However, a Z plasty may be required.

Revision canthoplasty should be done by experienced oculoplastic surgeon

There are revision canthoplasty techniques that can be performed. These procedures are rather difficult and complicated and need to be addressed in a consultation with an oculoplastic surgeon who has performed thousands of these types of surgeries. It is very important to go to somebody who is experienced with this type of work since it is a revision and is much more difficult to perform.

Distorted Skin from Canthoplasty

Z-plasty or a skin graft might be the answer. The distortion of skin is likely from wound contracture pulling on the skinof the lateral (side) upper eyelid and the brow. To minimize that pull you need scar reorientation using a technique called Z-plasty. Sometimes the scar tissue under the skin can be causing the distortion. In that case you have to open the old canthoplasty and do it all over again. Regards

Visit an oculoplastic surgeon

Sorry to hear you had a poor outcome from your surgery. I would suggest seeking out an oculoplastic surgeon. These surgeons are specially trained ophthalmologists who only perform eyelid reconstruction and cosmetic surgery.

D.J. Verret, MD

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Dallas Facial Plastic Surgeon

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Canthoplasty results could be reversed

Yes, a canthopexy could be reversed and revised. A picture would be very helpfull to determine the degree of canthal abnormality present and the need for different surgical techniques to address them. A word of caution: it is always wise to wait until the lower eye lid "settles in the final location" before attempting repair as long as the eye protection mechanisms are intact.

Tough Problem to Correct

In my opinion there are only a handful of MD's who I would think have the expertise to repair this type of deformity. For those who are a little less knowledgeable a canthoplasty is usually done when the lower eyelid lacks sufficient support. It is an operation that might be a little overused in my experience and should only be done by someone with tremendous expertise in obtaining an acceptable cosmetic result. Beware of the surgeon who only occasionally does this procedure or the... more

Repairing Canthoplasty results require specialized knowledge and techniques

Dear SaraFina Lower blepharoplasty performed through an incision below the lower eyelid lashes can easily distort the lower eyelid and the lateral canthal angle. Often inexperienced (and experienced) surgeons may not possess the training and experience to analyze the post-surgical problem and repair it. It is not unusual for me to see individuals who have had several "corrections" of the problem by well meaning surgeons who made the problem worse rather than better. What you need... more