Should I consider surgical options such as canthopexy/canthoplasty lift or conservative options such as Botox? (Photos)

Question

I am 46 years old. I am beginning to see my right lower lid sitting lower than my left eyelid. I also am aware that my right side has lost more volume than the left. The asymmetry in eyelid position is evident during rest and not as much during smile. I am also aware of the eyebrow asymmetry but that does not bother me much. Should I consider surgical options such as canthopexy/lift or conservative options such as fillers or botox?

Bilgen Katipoglu Erenoglu, MD · Answer

Hi, Isa414. Thank you for your queston and pictures.
As your eye angles are fine (positive vector), I wouldn’t suggest you to have a canthoplasty. Instead, a fat injection to the malar regions and also to the tear troughs will help more. (Right side will recieve more volume) Fillers can also restore the volume loss but it is a temporary solution and will need to be done again. The skin laxity that has started in your lower eyelids are best treated with a fractional carbondioxide laser. That treatment isn’t suggested in summer. The treatment volume asymmetry between right and left will solve your problem.

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