Unfortunately this procedure has become popular even among surgeons who have relatively little training in perform this procedure. To state it another way: the procedure is a disaster in the hands of inexperienced surgeons. When I say inexperienced, I mean inexperienced with canthal surgery. For this reason there was a proliferation of procedures that attempted to provide the benefits of a cathoplasty without actually cutting the lateral canthal angle. This includes procedures such as canthopexy, coronocanthopexy, etc. I see two of three new consults a week for individuals who need a repair of a canthal procedure performed by well meaning surgeons from various specialities. Here is the key: canthal surgery does not really have the power to reshape the eyes. It should be reserved for individuals whose lateral canthal angle and disinserted or is lax for various reasons. Using it to make an "almond" reveals a fundamental ignorance regarding the power of canthal surgery. Generally canthal surgery is a reconstructive procedure not an aesthetic procedure. Understanding this difference is critical.