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Your canthal tilt is normal. You don't need a lateral canthoplasty. You have mild lower lid retraction (your lower eyelid is slightly rounded on the outside edge). It can be improved using a small graft on the inside of your lower eyelid. This will make it seem like you have positive tilt.You do also have a slight upper eyelid ptosis on the left (droopy eyelid). I would recommend you see an Oculofacial Plastic Surgeon (Oculoplastics) for these issues, which are admittedly subtle.
Eye shape is determined by multiple factors including eyeballs, eyelids, and bony orbits. You are likely referring to relative lower eyelid retraction (droopy lower eyelids) which can be elevated but need more detailed evaluation. See an expert.
In most individuals, the canthal tilt is neutral or positive. Neutral means that the inner and outer canthal angles are about level. Positive means that the outer canthal angle is higher that the inner canthus. Negative means that the outer canthal angle is lower than the inner canthus. We like a neutral or positive canthal angle. Yours are neutral. The surgery that raises the corner is called lateral canthoplasty. The surgery called canthopexy is not strong enough to permanently change the outer angle. Now before you run out and ask for this surgery, please understand that is generally not a cosmetic procedure but a reconstructive method. Over correcting the corner can look highly unnatural. Often surgeons who do this, destroy some of the lower eyelid. That makes fixing their work and restoring the shape of the eye challenging. Please be careful what you look for. Your eyes are beautiful but you appear to have a mild left upper eyelid ptosis. That is addressed with ptosis surgery not canthal surgery.
Malar mounds are difficult to treat. Some patients find improvement with Morpheus8. These treatments help stimulate collagen production to add underlying support of the structure and give a smoother contour. See a board certified plastic surgeon near you to learn more.
An upper blepharoplasty can help remove some extra skin so you have more visible upper eyelid or more eyeshadow space. The incision is hidden within your natural crease so there is no scarring. Hope this helps! Johnson C. Lee, MD Board-Certified Plastic Surgeon
I usually suggest using Thera-tears Extra ( it’s slicker not thicker) 3 times a day for a few weeks before the surgery to treat any unrecognized or borderline dry eyes so you don’t get a lot worse after. The same drops work great chilled every hour or two in the first two days after the sur...