How Can Canthoplasty Result Be Corrected?

A canthoplasty procedure was performed during my lower lid blepharoplasty and it has never felt or looked right. The blepharoplaty incision was made below the lashline, in a fold, and then curved sharply upward and joined to the canthoplasty incision.

That area now looks distorted and, oddly, the skin from my outer brow is pulling to the eye's corner in a visible line.

One surgeon has suggested laser to tighten, but I don't see how this can correct the poor tissue arrangement. Are there other ways to best correct this?

Doctor Answers 7

Revision canthoplasty should be done by experienced oculoplastic surgeon

There are revision canthoplasty techniques that can be performed. These procedures are rather difficult and complicated and need to be addressed in a consultation with an oculoplastic surgeon who has performed thousands of these types of surgeries. It is very important to go to somebody who is experienced with this type of work since it is a revision and is much more difficult to perform.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Laser will not correct canthoplasty deformity

Laser resurfacing will tighten the skin which is the opposite of what you want. You need to have the canthoplasty revised and released to drop the corner of the eye and lessen the fold of the upper eyelid and brow area.

This is a complex and delicate surgery, and requires an experienced board certified plastic surgeon who specializes in eyelid surgery.

Hopefully, partial release of the canthoplasty and revsion of the scar will suffice. However, a Z plasty may be required.

Distorted Skin from Canthoplasty

Z-plasty or a skin graft might be the answer. The distortion of skin is likely from wound contracture pulling on the skinof the lateral (side) upper eyelid and the brow. To minimize that pull you need scar reorientation using a technique called Z-plasty. Sometimes the scar tissue under the skin can be causing the distortion. In that case you have to open the old canthoplasty and do it all over again.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 107 reviews

Visit an oculoplastic surgeon

Sorry to hear you had a poor outcome from your surgery. I would suggest seeking out an oculoplastic surgeon. These surgeons are specially trained ophthalmologists who only perform eyelid reconstruction and cosmetic surgery.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Canthoplasty results could be reversed

Yes, a canthopexy could be reversed and revised. A picture would be very helpfull to determine the degree of canthal abnormality present and the need for different surgical techniques to address them. A word of caution: it is always wise to wait until the lower eye lid "settles in the final location" before attempting repair as long as the eye protection mechanisms are intact.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Tough Problem to Correct

In my opinion there are only a handful of MD's who I would think have the expertise to repair this type of deformity. For those who are a little less knowledgeable a canthoplasty is usually done when the lower eyelid lacks sufficient support. It is an operation that might be a little overused in my experience and should only be done by someone with tremendous expertise in obtaining an acceptable cosmetic result. Beware of the surgeon who only occasionally does this procedure or the surgeon who does the procedure mostly for reconstructive purposes on elderly patients.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.9 out of 5 stars 18 reviews

Repairing Canthoplasty results require specialized knowledge and techniques

Dear SaraFina

Lower blepharoplasty performed through an incision below the lower eyelid lashes can easily distort the lower eyelid and the lateral canthal angle. Often inexperienced (and experienced) surgeons may not possess the training and experience to analyze the post-surgical problem and repair it. It is not unusual for me to see individuals who have had several "corrections" of the problem by well meaning surgeons who made the problem worse rather than better.

What you need is a surgeon like myself who devotes a considerable portion of their practice to fixing these sorts of problems. Typically, grafted material is needed in the eyelid to control its shape and then the canthal angle needs to be reconstructed using a technique called a lateral canthoplasty. The key is that the position and shape of this corner must be controlled very precisely to obtain an improved appearance. Occasionally other reconstructive steps are needed. What you need can only be determined with a detailed personal consultation. But yes, there is help out there.

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

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.