Canthoplasty to Fix Uneven Eyes?

I am considering getting some surgeries in two areas that bother me a lot. My concerns are: (1) My eyes are uneven. I have big eyes, which people say are attractive, but some sclera shows on the bottom. Also the left eye has drooped on the lower lid making the eye seem bulgy and tired. It really bothers me. (2) My nose is nice from the profile, but from the front it looks a bit wide, especially when I laugh. When I pinch my nostrils together it looks fine. Can I only do alarplasty?

Doctor Answers 6

Fixing Scleral show and wide nostrils

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Canthoplasty can fix the excess scleral show you have but, I answer this question with caution.  It is important to know whether your eyes are more prominent than normal.  A canthoplasty can raise the lower lid and help better define the angle of the lower eyelid, but, the procedure needs to be done with caution in people with prominent eyes. 
To give you a visualization of what I am referring to it would be a similar situation as when we see a very heavy individual putting on a belt and then the belly just falls over the belt.  In a tight lower lid with a prominent glove, the eye will do the same thing. 
As far as your alar flare when you smile, I would suggest changing the width of your nostrils only if they appear widened when you are not smiling.  Otherwise, your nostrils will be too narrow and chronically pinched.  the surgeon you choose will likely be able to give you a good idea of what changes will help you achieve your goal.

Both can be done

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One of the things you will have to accept is that people are asymmetrical - they are born that way and no matter how much cosmetic surgery you have, you may never be symmetrical. It is possible to narrow a nasal tip with alar base resections, but you may need a tip plasty too. Be evaluated by a good plastic surgeon.

Scleral show and wide nasal tip

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Scleral show may be the result of poor lower lid tone. This can sometiems be corrected by canhtopexy or canthoplasty. As for the bulging eyes, you may need to be worked up for Thyroid disease.  Wide alar rims can be corrected by alarplasty.

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Fixing uneven eyes

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When you have scleral show either from the aging process or from prior surgery, a canthoplasty is one technique that can improve or alter the lower lid position. However, scarring can result and this can be unnatural. Also, if you have bulging eyes a canthoplasty can actually make the appearance look worse. I would see a surgeon with expertise in this procedure to make sure you are an appropriate candidate. Also, you can do an isolated alaroplasty to narrow your nostrils; however, most patients also have wideness to the rest of the nose that requires a more formal rhinoplasty. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Alar base resection and lower eyelid Blepharoplasty

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With the amount of information given, I can not say anything for sure. However, alar base resection to narrow the nose is a very reasonable thing for some people. Make sure you see an experienced rhinoplasty surgeon.

As for your eyes, you may have an early ectropion, or droop of the lower eyelid, the left worse than the right. Especially if this is so, and, most likely, even if it is not an actual ectropion, this probably requires more than just a canthoplasty. This too will require someone experienced. Frequently, though, a good Plastic Surgeon will have both qualifications.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Sometimes alarplasty is all you need to narrow the lower third of the nose

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One of the causes for a wide nose is excess flare of the nostrils. Occasionally fixing this alone can make the overall nose appear more slender. However, more often, when the nostrils are wide, so is the rest of the nose. I suggest you see a rhinoplasty specialist to discuss your options. I find that computer imaging is great for demonstrating isolated vs. overall changes for the nose.

You also asked about eyelid surgery and describe asymmetry. It is impossible to really give a qualified opinion without a personal evaluation.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 134 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.