Canthopexy revision to lift corners of eyes? 6 months post-op canthopexy

Question

Hello. I had a canthopexy 6 months ago I noticed that my eyes became round again and the corners of the eyes drooped. On the left side in the corner of the eye, I feel a subcutaneous suture and tension, and a visible scar formed in that place. Can I have a second operation to lift the corners of the eyes and how soon?

Kenneth D. Steinsapir, MD · Answer

For the same reason your original canthoplasty failed, a second canthoplasty will also not work. The surgeon who performed this is not alone in thinking that lateral canthoplasty is the repair for this. However, canthoplasty, even drill hole canthoplasty lacks the strength to repair your lower eyelid. You are short of soft tissue and presumable have contracted scar in this lower eyelid. You do not state it but this type of appearance is consistent with prior unsatisfactory transcutaneous lower blepharoplasty. To repair these, soft tissue needed to be permanently recruited into this lower eyelid. The lateral canthus needs to be repositioned under no tension to prevent subsequent stretch-back with healing. I have developed the definitive surgery for addressing this set of issues by vertically lift the midface to recruit skin and soft tissue into the eyelid space. This is held in position with a hand carved ePTFE rim implant fabricated for you at the time of surgery. This implant is fixed to the orbital rim with titanium micro screws and the implant is used to anchor the elevated cheek soft tissues. The eyelid margin is than shaped by a hard palate graft from the roof of the mouth. This allows the lateral canthus to be repositioned under no tension. I am attaching a video below that shows the method and a link on my website for this procedure. Stop getting isolated canthoplasty which is not repair your issues but it will use up the eyelid margin. An in person consultation is needed to confirm this plan for you. Your eyes can be your best feature.

C. Blake Perry, MD · Answer

You likely need more than just a simple lid tightening. Your lower lid would benefit from a spacer graft to help raise the eyelid. I believe simply tightening the corner will not last. Best to see an eyelid specialist.

Canthopexy revision to lift corners of eyes? 6 months post-op canthopexy

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