Lengthening lashline after bad lower blepharoplasty?

CHEL is an acronym for "canthoplasty horizontal eyelid lengthening." Guy Massry uses this expression on his website. It is not otherwise adopted in the field for what is a very commonly performed surgery: lateral canthoplasty. He proposes this surgery for eyelids that have a very particular stretch back of the lower eyelid after blepharoplasty. However, it is highly unusual for canthoplasty along to be a solution for post-blepharoplasty lower eyelid retraction and canthal shortening and rounding. Often canthoplasty is simply a component of other more definitive techniques needed to restore these compromised eyelids. I often see patients who have one or more inadequate reconstructive techniques applied in a misguided effort to aesthetically restore the appearance of a lower eyelid after a botched eyelid surgery. Surgeons are always looking for ways to short-cut the repairs these complicated eyelids need. The short-cuts are seldom right an often lead people to have multiple eyelid fixes until they find the right surgeon. I take a much more comprehensive approach to these eyelids. Most post blepharoplasty lower eyelid changes are not do to simple disinsertion of the lateral a canthus-that rare situation that does respond to isolated lateral canthoplasty. No most post-blepharoplasty lower eyelid compromise with lateral canthal disinsertion and lower eyelid retraction represent a true shortage of skin and soft tissue in the lower eyelid. Much more powerful and definitive methods are needed to permanently aesthetically reconstruct the eyelid. Please study the attached video so see an example of how this is done. There is no substitute for a detailed personal assessment. Your eyes can once again be your best feature. Don't let well meaning surgeons use up more of your precious eyelid tissue resources with procedures that have no hope of restoring your eyelids.

It is difficult to recommend a treatment without evaluating your eyelids in person. It sounds like you may require at least a canthopexy to help resuspend and resupport your eyelids and restore their original length as well as bring your eyelid back up. You may require other procedures such as spacers etc to depending on what is actually happening to your eyelid but this can only be determined with a proper history and a physical exmaination. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon​