I have lateral scleral show. I want to know if canthoplasty is a good option for me? Or dermal fillers? (Photo)

Canthoplasty shortens the lower eyelid.  It also can be used to elevate the lateral canthal angle.  The reason why canthoplasty will not help you is topology.  Your eye is a spherical structure.  The shortest distance on a spherical structure is a curved line.  Shortening the lower eyelid with a canthoplasty will force the lower eyelid margin below the curvature of the eye.  Think of what happens when a man with a big belly tightens their belt to hold up the pants.  The pants fall below the curvature of the belly.  The same thing happens with the eyelid.  Alternative procedures would be fillers.  They can modestly help.  The other alternative is a cosmetic orbital decompression to create more room for the eye tissues.  Here is the real problem.  None of these approaches is idea.  You will suffer aesthetically compared you your current appearance except for under eye fillers.  The filler is fussy.  Find a very experienced injector.

Dear FarzonThank you for your questions and photos!Your eye shape is beautiful. Changing the shape can be tricky and I would recommend that you carefully consider about making any changes.With Warm RegardsTrevor M Born MD

Sometimes, small tarsorrhaphy can be more helpful than the lateral canthoplasty. You also can get away with canthopexy rather than canthoplasty. 

Thank you for the question. This is a complicated issue, and I agree with others that there is not an ideal solution. Fillers would have a very minimal effect unless a lot is used -- and then you are likely to look over-filled or puffy all the time. Canthal repositioning is possible but very difficult to get exactly right. And if your eyelid/eye socket anatomy isn't suitable for the procedure, it can make the scleral show worse. It would be my recommendation to do nothing.

Your scleral show is not distracting, so it may be best to live with it, or consider an approach less invasive than surgery. We do not offer canthoplasty in our practice, but surgical repositioning of your lateral canthi may lead to a less desireable aesthetic appearance, and there is always risk, uncertainty and expense with a delicate oculoplastic surgery.We have seen improvement in scleral show using Silikon-1000, an off-label filler for permanent results. The majority of our experience is in patients who developed scleral show and lower eyelid malposition after lower eyelid Blepharoplasty. Your photos appear to show some lower eyelid hollowing, so depending on your examination, fillers may be considered. Thank you.Dr Joseph

Canthoplasty can have dramatic effect on appearance of eyes, but this procedure should not be taken lightly.  You have beautiful eyes, and minor degree of scleral show should not be routinely corrected.  Seek out an eyelid expert, with a number of years of practice, for an in person evaluation.