I have a prominent negative canthal tilt that makes my eyes look sad and droopy. Can this be raised permanently? (Photos)

Hello! Yes, there is a surgical fix for what you have: bilateral (both lids) lower lid retraction (downward displacement of lower lid edge such that there is white sclera showing below the "6 o'clock position" of the iris/colored part of the eye) with lateral canthal angle inferior displacement (downward position of the outer corner of the eye relative to normal). In nearly all situations, all this can be corrected with bilateral lateral tarsal strip procedure (aka Kuhntszymanowski procedure). It is a procedure done extremely commonly by oculoplastics subspecialists, like myself.