I've read if you get canthopexy you should get cheek lift to support it. Wondering if fat transfer (to the cheek area) would help provide sufficient support for canthopexy. Also, I feel constant downward pulling of my facial muscles, i'm sure this is what caused the need for a canthopexy to begin with. How long can I expect the results from the canthopexy to last? If the sutures came loose from this pulling and I needed it again, would i have the option of getting the canthopexy done again?
Consider Canthopexy and Fat Transfer?
Doctor Answers (7)
Canthopexy and ?
From your history it is not quite clear why you would need a canthopexy and the reason for the sensation of a downward pulling on your facial muscles. The reason that a cheek (midface lift) is combined with a canthopexy is typically that too much skin has been removed from the lower eyelids or there is scarring that caused lower eyelid retraction. A canthopexy should last indefinitely (I have not seen a published study regarding the longevity of the procedure), but it certainly could be performed again.
Canthopexy and fat transfer
Most canthopexy procedures are performed with permanent sutures to help hold up the lateral corners of the eyelids. A cheek lift is not necessary to support it. A fat transfer is not needed either. The lateral canthal weakness is usually related to a weakening of the ligament in the eyelid and lax skin or removing too much skin from a previous blepharoplasty.
Cheek support with canthopexy
There are many things we need to consider in this question. First, why do you need a canthopexy? Is your lower eyelid pulled downward? Have you had prior lower eyelid surgery with skin removal that has contributed to this? Or are you considering lower eyelid surgery or laser resurfacing that might put the eyelid at risk of pulling downward.
A canthopexy is performed to either pull up the lower eyelid into a more anatomically proper position, or to prevent downward pull when other surgery [laser resurfacing or lower lid blepharoplasty].
Sometimes, if there is too much tension on the lower eyelid from either lack of skin, or from cheek descent, a midface [cheek] lift is needed to take the tension off of the canthopexy and make it more successful and long acting.
Fat grafting to the cheek and tear trough has been shown to achieve support of the lower eyelid in the same way: by adding a foundation-type support to the lower eyelid, which would take the tension off of the lower eyelid and making the canthopexy more effective.
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Cheek support for lower eyelids
This is a complicated question and answer depends on the individual person. It is true that cheeks fall down because of volume loss and if adding fat to the cheeks, that helps lift and support the cheeks and to some extent the lower eyelid too. See an oculoplastic surgeon for evaluation.
Fat Grafting to Cheek and Canthopexy
Fat grafting to the cheek in the right patient is a good volumizing technique with few complications. A canthopexy or similar procedure can be done again.
Actually it is the opposite. For patients with poor tone of the lower lid, it is best when undergoing a lower lid procedure or mid face lift to have good support and that is why a canthopexy is often performed as well.