How is lateral canthoplasty different from lower eyelid retraction surgery?

If there is tension on the lower eyelids, that tension would pull down the lower eyelid and lateral canthus if that tension is not resolved via lower eyelid retraction surgery. Canthoplasty does not reduce the tension. Both can be done together.

Lateral canthoplasty in the West is typically for lower lid support. Lateral canthoplasty in Asia is typically to make the eyes wider. Based on your other posts, you may need to specify what your specific goal is.  Lateral canthoplasty in the traditional procedure is designed to correct or prevent lateral retraction; lateral canthoplasty to to enlarge the outer parts of your eye is done to make the eye appear wider by tilting the eyelid downward.

Patients are over-promised with what this surgery does.  This has to do with how eyelid surgeons are trained.  They do not fully understand how the weight of the cheek pulls on the lower eyelid.  The lower eyelid can be permanently damaged by lower eyelid surgery causing the eyelid to sag.  It is commonly believed that tightening the lower eyelid with a canthoplasty will fix this problem.  It is a rare person who is fixed by lateral canthoplasty.  I have developed specialized methods to fix lower eyelid problems that cannot be fixed by lateral canthoplasty alone.  The biggest problem is prior motor nerve injury by a prior transcutaneous (through the skin) lower eyelid surgery.  Combined with removal of skin and the development of scar, lateral canthoplasty can't overcome these issues.  Correction requires the lifting of the cheek supported by a rim implant (this brings in skin and soft tissue into the lower eyelid). Typically a hard palate graft from the roof of the mouth is also needed to shape the lower eyelid and yes, a lateral canthoplasty is used to complete this procedure.  There is no substitute for a person to person consultation to determine precisely what you need.

Your question is a good one, and the answer can be confusing due to the subtle differences in how the lower eyelid procedures are named. Lower lid retraction can be secondary to several causes, and the procedures to correct the retraction may differ accordingly. In general, the operations are designed to elevate the lid on the globe (eyeball) tighten the attachment of the lateral lid to the bony rim. There are many variations as to how this done depending on your specific anatomy. Only a consultation with an experienced  surgeon can determine what would work best for you.

A lateral canthoplasty can be used to correct lower eyelid malposition, however it may not always be enough. It is important to have an in-office examination to determine the exact cause of your problem to determine the most effective and safest treatment plan. If lower eyelid retraction is due to tissue loss, scarring, or other cause, those issues must be addressed at the same time to allow the canthoplasty to lift and reposition the lower eyelid. Hope this helps!Johnson C. Lee, MD Plastic Surgery