My Eyes Slant Making Me Look Angry/tired? (photo)

What would be the best approach to improve the look of my eyes. I'm only 28 but the sloping has caused lots of wrinkles/bags around my eyes and make me look tired / angry all the time. One eye is also much bigger than the other. What are my options? Thank you!

Doctor Answers 3

Canthal dystopia

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Usually, I wold say that doing a canthoplasty/canthopexy is not a great idea, but in your case, I might make an exception.

You have what in the medical field is called lateral canthal dystopia, which used to be called "anti-mongoloid" slant to the eyes [this term has fallen out of favor for obvious reasons].

The lateral canthus is the outside corner of the eyes, where the upper and lower eyelids come together. The outside corner of the eyelid, is normally about 1-2 mm higher than the inside corner [medial canthus] of the eye in caucasians, and sightly higher than that in Asians.

When it is lower, it gives the eye a sad or tired look that you describe. In your case the  outside edge [tail] of the brow also follows form and is slightly droopy as well. You don't provide a full face photo, but if you did, I would venture that you have a slightly flat midface as well, which usually goes along with this type of facial feature.


Performing a lateral canthoplasty/canthopexy procedure can alter [raise] the position of your lateral canthus, and is something that I might consider. But I would warn you, that this will significant change the shape of your eye, and probably your overall look. This is something that you should consider very carefully before deciding on surgery. Some patients end up being unhappy with the surgery because they feel :  "I don't look like ME anymore".

Not trying to talk you out of surgery, but just setting expectations for you.

Good luck

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Slanted eyelids

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There are a few surgical maneuvers that can help with the downward slant.  This includes a canthopexy, and re-defining the upper lid crease laterally.The partial trade-off is that here may an extended incision laterally into the crow's feet area.  A canthoplasty is another option that would drastically change the shape of you eye.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Surgery for slanting of the eyes

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It looks like your upper lid is heavy and slanting.  Correcting it really requires surgery to change the shape and remove the heaviness of the upper lid as well as the downward sloping of the lower lid. From what I can tell from the picture, I don’t think filler or even Botox would be helpful without surgery.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

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