Canthoplasty or Canthopexy to fix mild lower lid retraction? (photo)

Question

Would a canthoplasty or canthopexy be enough to fix this mild lower lid retraction? I don't want to lengthen or shorten my eyes, I just want to tighten the lower lid and suspend my canthal tilt to a more neutral position.

David K. Isaacs, MD, FACS · Answer

Neither canthoplasty nor canthopexy will help.
I trained with Dr. Norman Shorr, the inventor of the Madame Butterfly procedure, a revolutionary approach to lower eyelid retraction. People from all over the world would fly in to have surgery. Since then we have modified this procedure to address different problems and aspects of lower eyelid retraction, since not all lower eyelid retraction is the same. We have also added newer techniques e.g. fat transfer to help with some of the morphology or anatomical variations or postoperative sequelae.

See an expert for an evaluation.

Mehryar (Ray) Taban, MD, FACS · Answer

Neither canthoplasty or canthopexy alone would effectively/reliably elevated the lower eyelids. What needs to be done is lower eyelid retraction surgery. See an expert.

Kenneth D. Steinsapir, MD · Answer

The cause of lower eyelid retraction makes a difference. Post blepharoplasty lower eyelid retraction does not respond to tightening the lateral canthal angle. Neither canthoplasty or canthopexy has the power to accomplish what you are showing in your second photo. Surgeons attempting this will use up your lower eyelid without accomplishing your goal. It will use up resources and make it much harder to repair your lower eyelid retraction. I developed a highly reliable repair for lower eyelid retraction. It involves vertically lifting the cheek to recruit into the lower eyelid space and supporting the cheek with an ePTFE rim implant. The eyelid is also reshaped using a hard palate graft. This allows the lateral canthus to be repositioned without tension. I am attaching a graphic video that shows how this is accomplished. There is no substitute for a detailed, in person consultation.

Canthoplasty or Canthopexy to fix mild lower lid retraction? (photo)

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Everything you need to know about Eyelid Retraction Repair

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Canthoplasty or Canthopexy to fix mild lower lid retraction? (photo)

Answers (3)

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Recommended reading

Everything you need to know about Eyelid Retraction Repair

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