Do I need a canthopexy? (Photo)

Question

Hey im 21 years old and some people have pointed out that i need canthopexy. after finding it out i have been really insecure about my eyes and want to get something done about them. any advice on how and/or how much it will cost?

Mehryar (Ray) Taban, MD, FACS · Answer

Canthopexy will NOT work for you. If you are trying to get more almond shaped eyes without sclera show, you need the lower eyelids lifted plus canthoplasty. See following website page discussing almond eye surgery.

Soheila Rostami, MD, FAAO, FAACS · Answer

the treatment of these type of eyelids is canthoplasty or canthopexy. It appears to be mild and you should not concentrate on this issue. As long as your eyes are feeling fine, and has no sign of irritation, I believe you are fine to let it be.

Reza Momeni, MD, FACS · Answer

No one NEEDS a canthopexy, unless they have problems related to ectropion (happens to much older patients) that necessitate the surgery to protect their cornea and ultimately their vision.  For cosmetic purposes, the question is whether you would LIKE a canthopexy or not.  If you're open to the idea of surgery, 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.

Darab Hormozi, MD · Answer

The main cause of your lower lid sclera show seems to be a shallow projection of your cheeks and lack of support for the lower eyelid.  Cantopexy most likely will give you a rounded corner if the cheek is not elevated.  You must be careful in choosing your surgeon since a wrong correction can accentuate your problem.

Ira Vidor, MD · Answer

Hi. You do have a little lower sclera show, but I think your eyes look fine. If you are significantly bothered and really want to pursue a surgical option, then you would likely benefit from adding support to your lower lid (by adding a lower lid spacer graft, adding volume, or lifting your cheek). A canthopexy would be an adjunct procedure. Again, I would probably leave it alone unless you are severely bothered. Hope this helps. Best regards, Ira Vidor, M.D.

Joshua A. Halpern, MD, PA · Answer

It appears from your pictures that you can see white (AKA sclera) below your pupil. You would need a physical examination to confirm that this is the normal resting position of your lower eyelid. If this is the case, and you have good lower eyelid tone, you maybe a candidate for an Endoscopic cheek lift. This is procedure that I helped  to  pioneer. The entire cheek and eyelid is  elevated though a small incision mainly in your lower eyelid. You would need a physical exam to confirm this. If you have poor lower eyelid tone, you would be a candidate for  either a canthopexy or canthoplasty. The canthus is a  (tendon) that anchors the corner of your eyelids to your skull. Please note that these two procedures (especially the canthoplasty) can change the tilt, i.e. angle, of your lower eyelid. This can change how you look to others. I hope you find this information useful. For more information please watch the enclosed video.

John R. Burroughs, MD · Answer

Looking at your photos, I think you already have nice appearing eyes.  If you are troubled by them then a canthopexy could be done laterally to raise the outer corner of the eyelid and reduce the scleral show (white of the eye) that is showing.  This can also give more of a cat eye appearance or almond shape that many women seek.  Canthopexies can be tricky to get completely symmetric, and oftentimes need repeating after several years.  Seek a qualified surgeon with great reviews and local/national reputation in your area.  Best regards.

Andrea Lora Kossler, MD, FACS · Answer

Thank you for your question. I think you have beautiful eyes with a unique look. The reason why others have mentioned a canthopexy is because your lower lid position and canthal angle (the outer corner of the eyelid) are lower than normal. This results in showing more of the sclera (white part of the eye) below your cornea (center part of the eye). Typically the lower lid sits at the corneal limbus (where the cornea and sclera meet- you can also think of it where the white part of sclera meets the center part of the eye which looks brown) and the outer corner of the eyelid is typically 2 mm higher than the inner corner. 
If the appearance of your eyelids bothers you or if you are developing eye irritation or tearing then you would be a good candidate for canthal surgery. There are many options for canthal surgery including canthopexy (tightening the corner of the eyelids) and canthoplasty (moving the corner of the eyelids). I recommend an evaluation with an eye plastics specialist to have a full exam and discuss your options. Good luck! You look great no matter what you decide.

Mehdi Sina, MD · Answer

Hi,
Thank you for including a photograph. As you likely already know, a canthopexy is used to tighten the lower eyelid. While you have a unique shape to your eyes, it is not possible to tell if you have excessive laxity of the lower eyelids. A canthopexy is used to tighten the lower eyelid and to treat ectropion which is the eversion of the lower eyelid with exposure of the red mucosa. I recommend a consultation with a specialist who can examine your lower eyelid for laxity and proceed from there.
Good luck,
Mehdi Sina, MD

William H. Gorman, MD (retired) · Answer

Based solely on your photo and from your statement that you have always been concerned about the appearance of your eyes, I believe you may well be a candidate for a canthopexy. I suggest you consult with a board certified plastic surgeon or ophthalmic plastic surgeon for evaluation and options. The cost will vary by region and by the exact procedure performed. First you should have a consultation, get good information, including costs, recovery time, risks, down time, etc. then you can make an informed decision. Best wishes!

Do I need a canthopexy? (Photo)

Answers (10)

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