Revision lateral canthopexy - How soon can I do it? (Photo)

Question

I had lateral canthopexy. expectation was my lower eyelids to be tightened to achieve an almond eye look. i think the doctor was too conservative. not happy with the result. i get my stitches taken out next week. can this be revised? I want to fix it right away. I understand that final result will show in months to come but immediately out of surgery i believe that result is close to what i would see. i dont expect my lower lids to tighten any further. Your advice would be truly apppreciated

Mehryar (Ray) Taban, MD, FACS · Answer

Canthopexy, or even canthoplasty, alone will NOT give more almond shape eyes IF the lower eyelids are sitting too low. Additional steps are needed. Please see following link and video for more information. Yes, revision surgery can be done.

Kenneth D. Steinsapir, MD · Answer

Your concerns that you have a problem are absolutely correct.  This is not going to fix itself with more time.  Your lower eyelids are not worse than before.  I did mention this to you in an earlier post.  I have colleagues to claim to do the same type of repairs I do.  Unfortunately that is not accurate.  They limit their work to attempting to improve the lower eyelid with canthoplasty.  The problem is that the canthoplasty does not have the power to fix what is going on with your eyelids.  Your issue is caused by a deficiency of orbital rim projection and soft tissue in the lower eyelid.  The repair requires the cheek to be vertically lifted to bring soft tissue into the eyelid space.  This requires a way to anchor the soft tissue to the orbital rim and for this I use a ePTFE rim implant that is hand carved for my patient at the time of surgery.  This is anchored to the orbital rim with titanium microscrews. This makes the implant very strong to support the weight of the cheek.  This brings the needed soft tissue into the eyelid to help with the deficiency of vertical height of the lower eyelid.  A hard palate graft borrowed from the roof of your mouth and sewn into the back of the lower eyelid to control the shape of the lower eyelid. Finally the lower eyelid is closed with a canthoplasty but the canthoplasty does not carry the weight of the eyelid.  You suggest that your surgeon was not aggressive enough.  That is not accurate.  I think your surgeon was too aggressive with removal of tissue.  This shortens the lower eyelid and instead of raising the lower eyelid it forces the eyelid under the curvature of the eye.  This is a well known issue with using canthal tightening.  Now you have a problem and will need a definitive repair.  Again, I am sorry you did not get the result you hoped for.

Mark Beaty, MD · Answer

You need to allow time for the initial swelling from your procedure to dissipate.  At this point sutures are not even out, it is much to early to evaluate results.  Be patient and I expect you will see your result improve with time.

Paul Nazemi, MD · Answer

Thank you for your question and photos provided.  It is too early to determine the final result of your surgery.  Once the swelling and bruising have resolved, you can then explore the possible need for revisional surgery with your surgeon.  Revisional surgery, when indicated, is typically performed about 6 months after the initial surgery.  Keep in mind that not all humans respond exactly the same to the identical procedure, and re-operations may be required at times, even in the best and most experienced hands.  Best wishes.

Edward J. Ricciardelli, MD · Answer

It is too early to judge the final position of the lower lid.  You haven't even had your sutures out yet.   The lid position will be affected by swelling and other factors, so give it at least 6 weeks before making a judgement.  Revising too early would be a mistake.

Revision lateral canthopexy - How soon can I do it? (Photo)

Answers (5)

Answer: Revisional eyelid surgery

Answer: Revisional eyelid surgery

Answer: Lateral canthopexy

Answer: Lateral canthopexy

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Revision lateral canthopexy - How soon can I do it? (Photo)

Answers (5)

Answer: Revisional eyelid surgery

Answer: Revisional eyelid surgery

Answer: Lateral canthopexy

Answer: Lateral canthopexy

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.