What are my options to correct the slope of my lower eyelid? (Photo)

Hi and thank you for your question and photograph. It appears that your lower eyelid is a bit lax or loose. This can be corrected with a canthopexy or canthoplasty. In a canthopexy, the incision is usually in the crease of the upper eyelid. A stitch is placed to tighten the edge of the lower eyelid and suspend it to the lining of the orbital rim bone (periosteum). Because your photograph is a little zoomed in, its difficult for me to assess the rest of your lower lid region and periorbital region. I don't know of a non surgical solution for this problem.

Blepharoplasty prices can range widely depending on their complexity and the issues being addressed. It can range from $2000-$10,000.

Be sure to see a board certified facial plastic surgeon or oculoplastic surgeon.

Hello, This is Dr Özge Ergün
It's perfectly reasonable that you're seeking consultation about eye contour aesthetics. The eyes are the most striking features of the face and directly affect the expression of your gaze. The term "negative lower eyelid tilt" you mentioned refers to a condition where the outer corner of your lower eyelid (lateral canthus) is lower than the inner corner. This can give the eyes a tired, sad, or droopy appearance. As a plastic surgeon, we can evaluate both non-surgical and surgical options to correct this condition.
Non-Surgical Options
Unfortunately, there is no non-surgical method that can permanently convert a negative lower eyelid tilt (negative canthus tilt) to a positive or neutral one. The main cause of this condition is the anatomical structures around the eye, particularly the position of the connective tissues (canthus tendons). Injections such as fillers or Botox can be used to fill in hollows under the eyes or soften crow's feet lines, but they cannot change the structural slope of the eyelid. Such injections are intended only to alleviate peripheral problems and cannot permanently elevate the position of the outer corner of the lower eyelid. Surgical Options
The only permanent and effective way to correct a negative lower eyelid slope is surgery. The surgical technique used to perform this procedure is called "lateral canthoplasty."
What is Lateral Canthoplasty?
Lateral canthoplasty is a surgical procedure performed to raise the position and shape of the outer corner of the lower eyelid (lateral canthus). It is usually performed under local or general anesthesia and can last from one to two hours. During the procedure, the surgeon cuts the connective tissue at the outer corner of the lower eyelid (lateral canthus tendon) and reattaches it to a point higher, closer to the bone. This permanently pulls the slope of the lower eyelid upward.
Benefits of the Surgery:
* Gives the eyes a more youthful, vibrant, and "awake" appearance.
* Corrects the "droopy eye" or tired look.
* Creates a more aesthetically desirable appearance known as "positive canthus tilt," where the outer corner of the lower eyelid is higher than the inner corner.
Recovery Process:
Mild swelling and bruising are normal after the procedure. These effects usually subside within a few days. Most patients can return to their normal lives within a week. Full recovery and final results may take several weeks to become apparent. Because surgical incisions are typically hidden within the lash line or natural creases of the eyelid, scars are minimal and fade over time.

The ideal relationship between the inner and outer canthus( either corner of the eye where the lower and upper eyelids meet) should be as follows: the outer canthus should be positioned 15 degrees above the inner canthus. This relationship is called "Tilt." If they are at the same level, then the tilt is neutral. If the outer canthus is below the inner canthus, then the tilt is negative. In your photo, your tilt is almost neutral, but there is a retraction of the lower eyelid (not necessarily the outer canthus) that causes a separation of the eyelid margin, which is called "Ectropion". There is no non-surgical solution; if you want to correct this, your best option is to have an in person evaluation to understand why you have this retraction and what is causing it. The solution may be a canthopexy or a canthoplasty.