Can Asian Lateral Canthoplasty/canthotemy be reversed? Are there long term consequences in stability with redoing this? (Photo)

Question

I received lateral canthoplasty in Korea in 2011 and the outer corner of my left eye was too droopy, too elongated, and you can see a lot of pink conjunctiva. I got a revision on it in 2012 but I still feel like the outer corner was not elevated enough or shortened. Is there a way I can get my eyes back to the original shape? Are there long term consequences in stability with redoing this for the second time? Thank you.

Amiya Prasad, MD · Answer

Elongating the outer canthus or the outer corners of the eyes
is very popular in certain areas of the world where a lot of Asian eyelid
surgery is performed.  This procedure
tries to create a longer-looking eyelid. In your situation, you have some
rounding of the lower eyelid. Although the pink part of the conjunctiva is not
seen, the eyelid looks low and you see a lot more of the white of the eye than
you normally would when the eyes are an almond shape. We often call this position
lower eyelid retraction where there may be some loss of integrity of the
tendon.

With a physical exam, I try to determine the basis for the
lower eyelid position. In many situations, it’s a combination of anatomic
factors like the lateral canthal tendon that is responsible for the position
and the suspension of the lower eyelid. I suspect it’s been affected since
there’s a rounding of the outer corner. In addition, the vertical support of
the lower eyelid may need to be reinforced. Although you didn’t have a typical
complication of lower eyelid blepharoplasty where there’s a loss of tissue
resulting in contraction and pulling downward, you may still have a relative
weakness in this area. You may need some type of vertical support. In our practice,
we use materials such as Enduragen which is the backbone of the skin that has
been treated in a way so that it can be used as a graft, or use acellular
dermis. The point is, a vertical support may be part of a strategy for you.

In the absence of a physical exam, I can’t tell exactly what
you would need. Meet with cosmetic surgeons with extensive experience in lower
eyelid revision surgery as there’s a distinction - most plastic surgeons don’t
have expertise in this type of surgery as opposed to specialists such as an
oculoplastic surgeon or a board certified cosmetic surgeon who has specific
specialty-based experience in this area. When you meet with these kinds of
doctors, you’ll understand whether or not you’ll need vertical support in
addition to some type of anchoring procedure to get the lower eyelid to proper
position.

You can reverse or enhance your results, but it won’t likely
be a straightforward simple procedure. You have to decide how important the
result is to you and if the healing time is worthwhile to achieve your
objective. I hope that was helpful, I wish you the best of luck and thank you
for your question.

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Luis A. Cenedese, MD, FACS · Answer

Lateral canthoplasty may be revised as a tertiary procedure.  The goal of improvement rather than reversion to a previous appearance will more likely attainable. Cheers. Please consult in person with an experienced Board Certified Plastic Surgeon prior to making treatment decisions. Cheers.

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

There is no way to revert to your original lid. Nonetheless, revision surgery may offer some improvement. Have your eyelids evaluated by a board certified surgeon who specializes in these procedures.

Can Asian Lateral Canthoplasty/canthotemy be reversed? Are there long term consequences in stability with redoing this? (Photo)

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Everything you need to know about Canthoplasty

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Can Asian Lateral Canthoplasty/canthotemy be reversed? Are there long term consequences in stability with redoing this? (Photo)

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Everything you need to know about Canthoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.