Q: Canthoplasty pros and cons

Pros Canthoplasty surgery can make your eyes appear larger and brighter, with a cat or “fox eye” shape that’s widely considered attractive. It can give eyes with a negative canthal tilt (a genetically downturned appearance) a happier or more awake look. It can correct the effects of aging, like sagging and excess skin, as well as medical conditions, such as outwardly-turning (ectropion) eyelids or chronic dry eyes. It can also address drooping or laxity of the lower eyelid caused by trauma or previous surgical complications, like retraction, where the lower lid pulls down. Incisions are hidden within the natural lid crease to minimize scarring. Cons You’ll need two to three weeks off work for recovery. Changing the shape of the eye can sometimes make patients look very different, even unrecognizable to themselves, since the eyes are central to our personal, ethnic, and familial identity. Because reversing a canthoplasty procedure can be difficult, undesirable or asymmetrical results may be hard to repair. Some surgeons do not recommend canthoplasty strictly for cosmetic reasons, especially in young patients seeking surgery to follow a trend (like the fox eye lift).

Question 1

What is canthoplasty?

Accepted Answer

Canthoplasty surgery, also known as cat eye surgery, is a type of cosmetic eyelid surgery that alters the lateral canthus (the outer corner of the eye, where the upper and lower lid meet) by tightening and elongating the eye horizontally, to give it what’s known as a positive canthal tilt or upward slant.

By adjusting various muscles and ligaments, this type of oculoplastic surgery alleviates drooping at the outer corners of the eye and creates an almond-shaped or “cat” eye, which is why it’s sometimes called a cat eye lift.

The cosmetic procedure was traditionally performed to correct age-related upper eyelid laxity, but many younger patients in their 20s and 30s seek out this eye-shape-altering cosmetic surgery after seeing its results on social media and wanting more of an almond eye shape.

Lateral canthoplasty is often performed alongside a blepharoplasty (upper or lower eyelid surgery) or double eyelid surgery, but it’s a more specialized procedure that can be more technically challenging. For this reason, it’s best performed by a board-certified oculoplastic surgeon with membership in the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), both indicators of extensive training in ophthalmic reconstructive and cosmetic surgery.

Related: The Little-Known Eye Lift Procedure That’s Taking Over Hollywood

Question 2

Canthoplasty pros and cons

Accepted Answer

Pros

Canthoplasty surgery can make your eyes appear larger and brighter, with a cat or “fox eye” shape that’s widely considered attractive.
It can give eyes with a negative canthal tilt (a genetically downturned appearance) a happier or more awake look.
It can correct the effects of aging, like sagging and excess skin, as well as medical conditions, such as outwardly-turning (ectropion) eyelids or chronic dry eyes.
It can also address drooping or laxity of the lower eyelid caused by trauma or previous surgical complications, like retraction, where the lower lid pulls down.
Incisions are hidden within the natural lid crease to minimize scarring.

Cons

You’ll need two to three weeks off work for recovery.
Changing the shape of the eye can sometimes make patients look very different, even unrecognizable to themselves, since the eyes are central to our personal, ethnic, and familial identity.
Because reversing a canthoplasty procedure can be difficult, undesirable or asymmetrical results may be hard to repair.
Some surgeons do not recommend canthoplasty strictly for cosmetic reasons, especially in young patients seeking surgery to follow a trend (like the fox eye lift).

Question 3

How much does canthoplasty cost?

Accepted Answer

Your price will depend on your surgeon’s credentials, their practice location, and the complexity of your procedure.

Health insurance will not cover cosmetic canthoplasty, but your surgery may be covered if your canthoplasty is done to correct a medical condition.

See our complete guide to canthoplasty costs

Question 4

How does canthoplasty surgery work?

Accepted Answer

Canthoplasty surgery is performed under either general anesthesia or local anesthesia with some form of sedation (oral or IV). It usually takes two hours or less.

Once you’re fully asleep or sedated, the surgeon will insert shields or apply antibiotic ointment to your eyeballs to protect them during surgery.
Your surgeon will then make tiny incisions near the outer corners of the eyelid.
Then they’ll lift, tighten, and reposition the lateral canthus, adjusting the lateral canthal angle.
Finally, they’ll secure it to the orbital rim with sutures, to give the eye a larger and brighter appearance.
Canthoplasty can be combined with blepharoplasty, since the incisions for the two procedures are in the same location.

Dr. Mehryar (Ray) Taban, a board-certified oculoplastic surgeon and ophthalmologist in Beverly Hills, explains that the desired shape is often achieved via a combination of upper and lower blepharoplasty. Your unique anatomy and desired result will determine the recommended treatment plan.

RealSelf Tip: Injectables, including under-eye fillers and Botox, can also rejuvenate and refresh the appearance of the eyes. By restoring natural volume and contours to the eyelids and surrounding areas, hyaluronic acid fillers can offer the illusion of a more lifted eye. Botox and other neuromodulators can also balance the muscle activity of the upper face, providing a subtle and temporary elevation of the brows and outer eyes.

Question 5

How long does canthoplasty recovery take?

Accepted Answer

As with other eyelid surgeries, it’s not uncommon for patients to need two to three weeks of recovery before returning to normal activities.

Here’s what to expect during the recovery period.

Your vision may be blurred or otherwise compromised for the first week, before you have your sutures removed and the swelling starts to resolve.
You’ll need to wear a protective dressing that may cover a portion of your eye or the eye area that’s swollen or bruised.
Expect swelling and bruising (and possibly dry eyes or excess tearing) for up to two weeks.
You won’t be able to wear eye makeup or contact lenses until you’re fully healed.
Avoid rubbing or straining your eyes or doing anything that might cause dry eyes, including excessive screen time or reading small print.
Skip exercise for at least a week.

Question 6

Is canthoplasty safe?

Accepted Answer

Canthoplasty risks common to any surgical procedure include the possibility of:

infection
bleeding
scarring
anesthesia complications

These complications should be rare if you follow your surgeon’s aftercare instructions.

Additional risks of altering your eye shape include:

asymmetry, after either the initial procedure or a revision surgery
ectropion, a condition where the eyelid sags or turns outward
chronic dry eye

Some surgeons, such as facial plastic surgeon Dr. Jonathan Cabin of Beverly Hills, don’t believe canthoplasty should be performed for cosmetic reasons. Dr. Cabin recommends that you speak to a board-certified oculoplastic expert if you’re considering it. Unless the patient has a medical condition, such as eyelid malposition (including ectropion or entropion eyelids), ptosis (drooping eyelid), or chronic dry eyes, he prefers to stick with a lateral brow lift or a combination of upper and lower blepharoplasty.

Question 7

Canthoplasty vs. canthopexy: What’s the difference?

Accepted Answer

A canthoplasty lifts the lateral canthus, while a less invasive canthopexy procedure strengthens and stabilizes the lateral canthal tendon and surrounding internal structures of the lower eyelid, without cutting or detaching the tendon and muscles.

Both eye surgeries can make eyes look younger. But rather than changing the shape of the eyes, a canthopexy improves muscle tone and helps elevate sunken eyelids.

Some surgeons also offer epicanthoplasty surgery, which can enlarge the inner corner of the eye.

Question 8

Sources & studies

Accepted Answer

Sources & studies

Chae, Soo Wook, and Byung Min Yun. “Cosmetic Lateral Canthoplasty: Lateral Canthoplasty to Lengthen the Lateral Canthal Angle and Correct the Outer Tail of the Eye.” Archives of Plastic Surgery, The Korean Society of Plastic and Reconstructive Surgeons, July 2016.

Naik, Milind N, et al. “Blepharoplasty: An Overview.” Journal of Cutaneous and Aesthetic Surgery, Medknow Publications, Jan. 2009.

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Jolene Edgar

Jolene Edgar

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Jolene Edgar

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