Is a Canthopexy Necessary when Perfoming Arcus Marginalis Release Procedure?

I saw a surgeon yesterday that suggested transconjunctival fat repositioning (AMR) for my hereditary eye bags and tear toughs (i'm 24). He would also perform a canthopexy, but I forgot to ask him why. Is this necessary with AMR ? Is there with this procedure a higher risk of ectropion then with conventional bleph? Do you perform a canthopexy when performing transconjunctival fat repositioning?Can a canthopexy be avoided?I have no excess skin and no skin is going to be removed (transc approach)

Doctor Answers 7

Canthopexy after transconjunctival fat repositioning

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Thank you for the question. It is in your best interest if you address that question with you plastic surgeon and before surgery. He is in a better position to give you a reasonable answer for doing this procedure. Generally speaking, Support of the lower lid with canthopexy is useful to avoid lower lid drooping after surgery. 

San Diego Plastic Surgeon

At age 24 it is very improbable that you need anything done to your canthal tissue.

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I recommend that you get some additional opinions.  You did not provide an photos but it is improbable that you need a canthopexy.  I would be wary of surgeons who want to throw the kitchen sink at you.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Canthopexy with AMR

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Most likely this is to support your lower lid after surgery.  Simply ask your surgeon why this is in the plan.  Also, if your bags are that bad at this age you likely have orbital bone or malar deficiency and would benefit from midface augmentation.


Best of luck.  Ask your doctor about the canthopexy.  


Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews


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A canthopexy is different than canthoplasty (which is sometimes required with eyelid surgery).  So, a personal evaluation & photos are required to answer your question fully.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews


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The details of your question reflect that you have done extensive research and that you are looking for a procedure which does have some complex aspects to it.
Assuming your surgeon is highly experience in this area, most likely your surgeon wants to avoid any problem related to the eyelid being malpositioned which would therefore require some type of lateral canthal procedure.
I am assuming you had several consultations before you came to the conclusion that this particular surgery is necessary.
Any procedure where the lower eyelid is at risk for being pulled down or retracted, in my experience requires some stabilizing procedure of the outer corner (lateral canthus).

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Photos will help

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At your age, it is unlikely that you would need a canthopexy along with the transconjunctival blepharoplasty. Please post a photo for our evaluation. Better yet, get a second opinion.

If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Canthopexy is used to support the lower eyelid after lower blepharoplasty

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Canthopexy is used to support the lower eyelid after lower blepharoplasty. If there is a lack of support in your lower eyelid the canthopexy will support the lid and prevent post-operative malposition of the lower eyelid. I will usually perform this for patient's who have weakness of the lower eyelid to prevent post-operative complications. I hope this is helpful for you.

Stephen Weber MD, FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.