Negative canthal tilt: Can a zygomatic implant + temporal lift elevate the outer corner of the eyes? (Photo)

Question

Hello dear doctors, Can a zygomatic implant + Temporal lift elevate the outer corner of the eyes ? Can this give similar results as a Canthoplasty?

Farhad Rafizadeh, MD · Answer

Your picture shows that the lateral canthus is lower than the medial canthus. It also shows that you could benefit from an anatomical cheek implant that could augment the anterior maxilla and inferior orbital rim as well as the zygoma and the anterior zygomatic arch. I do this operation through the lower eyelid in order to fixate the implant to at least two bony areas, usually the inferior and lateral orbital rim. This avoids any movement of the implant. You can also see that you have bowing of the lower lids with already some sclearal show. Therefore your are going to need lateral canthopexy or canthoplasty any way to elevate the lateral canthus, support the lower lid and avoid worsening the scleral show. This would be done even if you didn't have a negative canthal tilt.   Therefore the lateral canthal support must be part on any cheek implant operation for you. I hope this explanation answers your question. An in person evaluation is mandatory to validate what I have recommended here.

Mehryar (Ray) Taban, MD, FACS · Answer

Canthoplasty alone will NOT achieve the change you want in any long-term fashion since the tension in the lower eyelids will pull down the canthus and lower eyelid again unless that tension is released through lower eyelid retraction surgery to achieve long-term almond eye. Please see following website link for Almond Eye Surgery. The implant can help add volume but the lower eyelid elevation is a must. Skype consult available.

Reza Momeni, MD, FACS · Answer

implants and skin lifts will NOT lift or move the canthus, rather a cantonal repositioning will be needed.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.

Barry L. Eppley, MD, DMD · Answer

While a canthoplasty and cheek implant may be part of the treatment, they alone are not adequate. You have a lower lid vertical tissue deficiency which must be addressed by the addition of spacer grafts to support the lid position long term. This is particularly important in the more severely affected right lower eyelid.

Negative canthal tilt: Can a zygomatic implant + temporal lift elevate the outer corner of the eyes? (Photo)

Answers (4)

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