What is the LEAST amount of shortening that can be done of the lower lid when conducting a lateral tarsal strip canthoplasty?

My understanding is that any lateral strip canthoplasty requires the shortening of the lower eyelid. Wouldn't this also effect the upper eyelid to some degree?

Doctor Answers 3

Lateral strip canthoplasty

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  • About 2 mm.
  • But this is not a cosmetic procedure.
  • If it has been suggested to you as a cosmetic procedure, I suggest you get a second opinion from a Board Certified Opthalmoplastic Surgeon or Plastic surgeon before having this operation. Best wishes.

Canthoplasty is a structural surgery, not a cosmetic surgery.

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It can be a critical step in repairing an eyelid.  It is often needed to reconstruct the canthal angle after a swinging eyelid approach to the lower eyelid is used to access the orbit or lower eyelid.  Surgeons are mistakenly using it as a cosmetic service.  It is necessary to remove a small amount of the lower eyelid skin to create the tarsal strip that is a structural part of the canthoplasty.  I typically remove only 2 mm of skin.  However, I trained with someone who routinely removed 6 mm of skin.  This can be disfiguring.  Also an incision is made through the lateral canthal angle as the first step in performing the canthoplasty.  If this incision is made too long and too deep, it can damage the motor nerves that supply the upper eyelid orbicularis oculi muscle of the upper eyelid tarsal platform and this will weaken the blink and lead to dry eye.  You are asking a good question, but you may be looking for the wrong surgery.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Tarsal strip

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unfortunately this question can't be answered over the Internet.  Tarsal strip procedures or lid shortening procedures are most often performed and older patients for functional issues of the lower eyelids.  Occasionally, the lateral canthal tendon is very weak so permanent sutures have to be placed in this area to ensure that the corner of the eyes remain in place.  Shortening or affecting the upper eyelids isn't typically an issue.

Chase Lay, MD
double board-certified facial plastic surgeon

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

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