Consider Canthopexy and Fat Transfer?

I've read if you get canthopexy you should get cheek lift to support it. Wondering if fat transfer (to the cheek area) would help provide sufficient support for canthopexy. Also, I feel constant downward pulling of my facial muscles, i'm sure this is what caused the need for a canthopexy to begin with. How long can I expect the results from the canthopexy to last? If the sutures came loose from this pulling and I needed it again, would i have the option of getting the canthopexy done again?

Doctor Answers 7

Canthopexy and ?

From your history it is not quite clear why you would need a canthopexy and the reason for the sensation of a downward pulling on your facial muscles.  The reason that a cheek (midface lift) is combined with a canthopexy is typically that too much skin has been removed from the lower eyelids or there is scarring that caused lower eyelid retraction.  A canthopexy should last indefinitely (I have not seen a published study regarding the longevity of the procedure), but it certainly could be performed again.  

Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

Canthopexy and fat transfer

Most canthopexy procedures are performed with permanent sutures to help hold up the lateral corners of the eyelids.  A cheek lift is not necessary to support it.  A fat transfer is not needed either.  The lateral canthal weakness is usually related to a weakening of the ligament in the eyelid and lax skin or removing too much skin from a previous blepharoplasty.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Cheek support with canthopexy

There are many things we need to consider in this question. First, why do you need a canthopexy? Is your lower eyelid pulled downward? Have you had prior lower eyelid surgery with skin removal that has contributed to this? Or are you considering lower eyelid surgery or laser resurfacing that might put the eyelid at risk of pulling downward.

A canthopexy is performed to either pull up the lower eyelid into a more anatomically proper position, or to prevent downward pull when other surgery [laser resurfacing or lower lid blepharoplasty].

Sometimes, if there is too much tension on the lower eyelid from either lack of skin, or from cheek descent, a midface [cheek] lift is needed to take the tension off of the canthopexy and make it more successful and long acting.

Fat grafting to the cheek and tear trough has been shown to achieve support of the lower eyelid in the same way:  by adding a foundation-type support to the lower eyelid, which would take the tension off of the lower eyelid and making the canthopexy more effective.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Cheek support for lower eyelids

This is a complicated question and answer depends on the individual person. It is true that cheeks fall down because of volume loss and if adding fat to the cheeks, that helps lift and support the cheeks and to some extent the lower eyelid too.  See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Fat Grafting to Cheek and Canthopexy

    Fat grafting to the cheek in the right patient is a good volumizing technique with few complications.  A canthopexy or similar procedure can be done again. 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews


Actually it is the opposite. For patients with poor tone of the lower lid, it is best when undergoing a lower lid procedure or mid face lift to have good support and that is why a canthopexy is often performed as well.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews


In eyelid surgery patients that do not have adequate lower lid tone or support, and in any patient felt to be at some risk of ectropion, a lateral canthopexy is performed to protect against that potential problem. The lateral canthus (the lateral corner of the eye) contains a tendon that attaches the lower lid tissues to the orbital rim laterally, and this tendon serves as a 'clothesline' that maintains lower lid position. A lateral canthopexy consists of an anchoring or supporting suture that tightens that tendon and thus the lower lid as well. When desired, a lateral canthopexy can also elevate the position of the lower lid. In patients who desire it, this procedure can produce a more 'almond' shape to the eyes.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 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.