Canthoplasty and canthopexy is the tightening of the ligament or muscles that support the outer corner of the eyelid. Canthoplasty will reshape the eye while canthopexy will provide support without changing the shape of the eye. This procedure intends to correct or prevent the pulling down of the lower eyelid. Canthoplasty can also be used to create an upwardly slanted outer eyelid corner. This cat eye look is sought after by many. Canthoplasty has several other names like tarsal strip re-suspension, lateral retinacular suspension, and inferior retinacular suspension.

Who are the ideal candidates for canthoplasty?

The ideal candidates for canthoplasty include anyone with sagging lower eyelids. Sometimes, these eyelids can droop too low which is caused by prior eyelid surgery, aging, and even paralysis. Canthoplasty is usually performed in addition to eyelid lift, facelift, and brow lifts, although the procedure is commonly done on its own.

What is involved in the surgery and how long will it take?

There are a lot of surgical techniques in canthoplasty. The technique used will vary from patient to patient and from surgeon to surgeon. You must set an appointment with your surgeon to find out the various techniques and methods used for canthoplasty. In canthoplasty, the lower canthal tendon is divided, moved, and then tightened. An incision is made in the outer corner of the eyelids. On the other hand, in canthopexy, the lower canthal tendon is tightened with a permanent internal suture. These processes are done under local anaesthesia or general anaesthesia.

What are some things that I can expect from canthoplasty and canthopexy?

You must be realistic when setting your expectations. There will be a tightening and elevation of the lower lids and an improved youthful appearance to the eyes. You will end up having a completely natural look that will compliment the rest of your feartues.

Recovering from canthoplasty or canthopexy

What happens during the recovery period?

It is normal that in all surgical procedures, some swelling may occur. You will experience swelling and bruising but this should not be much of a problem. It will subside in a few days to a week and you can be up and about in no time. There isn’t much pain in this procedure.

One thing that you must keep in mind is to visit your surgeon regularly for follow up visits. Your surgeon must check your progress and make sure that you are doing okay. Sometimes, you may feel a little uncomfortable as your eyes may dry up too much. In this case, ask for prescribed drops from your surgeon.

How long will it take to recover from the surgery?

Since this procedure only affects a small area, there will be little pain only. There will be local swelling and bruising but this will eventually subside in a week. On average, all you need is one to two days off from work although this recovery period may vary from person to person.

More Information on Canthoplasty

What are the benefits associated with canthoplasty?

The main benefit from this kind of cosmetic surgery is the tightening of the tissues at either corner of the eye where the upper and lower eyelids meet. This will provide better support for the eyelid by lifting and strengthening the outer corners of the eyelids. Moreover, you will even reduce wrinkles and lift excess skin too. A more pleasing eye appearance or a cat eye appearance is the result.

One other aim of this procedure is to minimize the occurrence of surgical complications that can arise after a transcutaneous lower blepharoplasty. Here’s a brief list of the benefits one can derive from this cosmetic surgery.

  • correcting the drooping eyelids caused by ageing or previous surgery
  • reduction of risks associated with blepharoplasty
  • protection of the ocular surface
  • elimination of wrinkles
  • a rejuvenated eye appearance

Aside from these physical improvements, patients also get a lot of psychological benefits as well. Here’s a brief list of some of the psychological benefits from such surgery

  • improved self confidence
  • improved self esteem

Even if the physical improvements don’t make the patient happy, these psychological benefits help a lot.

One must understand clearly the benefits and the risks associated with this procedure. Before you go through this operation, you must discuss your expectations with your surgeon. You may also want to look into other surgeries that can be combined with canthoplasty or canthopexy. These are eyelid surgery, facelifts, mid face lift, and fat transfers.

Performing the surgery

There are several variations regarding the surgical techniques used in canthoplasty. The choice of procedure that is most appropriate for each patient will depend on

  • individual characteristics like the degree of sagging, prominence of the eyes, position of the eye in the orbital rim/cheek bone
  • patient’s preferences
  • recommendations of the surgeon based on their experience undergoing these techniques

Take note that canthopexy is suited for less prominent eye lid droopiness while canthoplasty is preferred for more severe eye lid conditions. An incision is placed at the outer corner of the eye near the orbital bony rim. The scar resulting from the surgery will be hidden in one of the eye creases. The incision will be closed using dissolvable and non absorbable sutures.

Various surgical techniques will be used to support the eyelids and they will be strengthened afterwards. For minimal reinforcement, simpler procedures will be used. In this situation, you can extract a full thickness in the lower eyelid. This allows the eyelid to grip the eye without the need to create stronger tendons or new tendons.

On the other hand, canthopexy involves tendon tightening. There will be various techniques ranging from simple to complex ones. More often, the soft tissues below the tarsal plate will be tucked by sewing them to the rim of the orbital bone.

In all these procedures, the most essential step is to attach the supporting tendon, muscle, and tarsal plate to the external lining of a nearby bone.

How long does the surgery take?

The surgery will take from one to two hours.

What are the risks involved in canthoplasty or canthopexy?

Risks and complications are an unavoidable circumstance in surgery. Here are some of the risks that can occur as a result of canthoplasty or canthopexy.

Adverse reaction to anaesthesia

There are patients who experience nausea and sickness after receiving the anaesthesia. This is merely temporary and will eventually go away after a few hours.


Infections are very rare although they can still occur after a surgery. Infections are treated with antibiotic ointments during the first few weeks after the operation.

Haematoma or blood clots behind the eyeball

It is very rare for blood clots to develop behind the eyeball or under the skin. Symptoms of this complication are steady, stabbing pains that are similar to glaucoma. In these cases, removal has to be done.


Scars are concealed within the crease of the eyelids so they won’t be as obvious. You may discuss this with your surgeon and even have before and after photos.

Alteration of eye sight

The eye sight is altered only on a temporary basis and will go back to normal in time.

What are some of the questions that I can ask my surgeon about canthoplasty or canthopexy surgery?

Getting as much information as possible is important in any surgical procedure. You must have an initial consultation with your surgeon to discuss matters related to the surgery. You will better understand the risks, benefits, and costs regarding the procedure. Some of the questions you may want to ask are listed here.

  • Am I a good candidate for canthoplasty?
  • Are my goals realistic?
  • What type of surgical technique will be used on me?
  • Why do you recommend this surgical technique?
  • What are some of the things that I have to do prior to the operation?
  • Is it possible for you to explain the details of the operation to me?
  • What are some of the benefits that I will avail of when I finish the surgery?
  • What are some of the side effects that I should expect after the surgery?
  • Will I experience any pain or discomfort after the surgery?
  • How long does it take before I can resume my normal day to day activities?
  • How long will the results of canthoplasty last?
  • What are the other cosmetic procedures that can be combined with canthoplasty?
  • What post operative care can I do to prolong the benefits of the surgery?

Am I a suitable candidate for canthoplasty or canthopexy?

Canthoplasty’s goal is to cure the sagging lower eyelids. Your eyelids can be too droopy or too low because of prior eyelid surgery, ageing, or even paralysis.

Canthoplasty is a highly specialized procedure and it can be combined with other surgical procedures like facelifts and brow lifts. More often than not, patients have this surgery alone. Consider canthoplasty if you are:

  • physically healthy
  • a non-smoker
  • having loose, sagging, or fatty lower eyelids
  • optimistic about how you can look
  • realistic on what can actually happen with the surgery

What is the suitable age for canthoplasty?

Most of the people who have canthoplasty are aged thirty and beyond.

Are younger people able to have canthoplasty?

For those with saggy, fatty lower eyelids, this procedure can be beneficial at an early age. It is wise to be twenty years or older before having any surgical procedure done. Take note that as your body ages; your cheeks will naturally lose fat.

Who is not suitable for canthoplasty?

People who have swollen, fatty-looking eyelids that are caused by an overactive thyroid gland or myxedema should not consider having canthoplasty.

Am I going to have dark circles under my eyes after canthoplasty?

Canthoplasty is not going to improve the dark circles below your eyes. It may improve the darkness if it is caused by the bulging of fat in the lower eyelids.

Can I combine canthoplasty with other cosmetic procedures?

Canthoplasty can be performed as a stand alone procedure or it may be combined with other cosmetic surgery procedures like facelifts, liposuction of the neck, and rhinoplasty or nose correction.

What is the first step in canthoplasty?

The first step in canthoplasty is acquiring as much information as possible. It is wise to set up an appointment with your surgeon as soon as possible. You can discuss your goals with your surgeon. You will be notified of the risks, costs, and complications that can arise from the surgery. You will be asked about your reasons on why you want to have such surgery. Your surgeon will also ask you for your medical history so that no further complication occurs. At the end, you will be assessed whether you are fit or unfit to proceed with the surgery.

What are some of the things that I should do in order to achieve the best results?

Some of the things that you should do in order to achieve the best results are

  • maintaining a proper diet
  • avoiding smoking or completely quitting
  • taking or avoiding certain vitamins, iron tablets, and medications

What should I do when I get home after canthoplasty or canthopexy?

You will experience some swelling and bruising after your surgery. This is normal and will eventually subside over the weeks. In fact, you may be up and about in just a few days. There should not be much pain although you can request some prescription medications from your surgeon if pain persists. Your eyes may feel a little dry also. You can get prescription drops for this as well.

You should avoid any activities that will dry up the eyes for the first few weeks. This includes

  • reading
  • watching the television
  • watching movies
  • wearing contact lenses
  • playing videogames
  • surfing the internet
  • typing on the computer

Is it possible to minimize the bruising and the swelling after the surgery?

For the first few days after the surgery, you can keep your head as elevated as possible in order to minimize the swelling and the bruising.

How are my stitches going to be removed?

The surgeon will remove the stitches after a week from surgery.

Will I be able to wash my face after the surgery?

You may wash your face one day after the surgery.

Will I be able to wear make-up after the surgery?

You may wear make-up one day after the surgery.

When can I resume my normal day-to-day activities?

At around the tenth day of recovery, you may resume your normal day-to-day activities.

What are some ways where I can protect my eyes?

Here are some of the ways where you can protect your eyes after the surgery.

  • Wear dark sunglasses for the first couple of weeks in order to protect your eyes from the sun and wind
  • Take frequent naps because your eyes will get tired easily
  • Avoid activities that increase the blood flow to the eye. This includes bending, lifting, sports, and crying

When can you resume exercising at the gym or running outside the house?

You must ask your surgeon for more details on this matter.

When can you return to work and become productive again?

Normally, people will take one to two days off from work but this will definitely vary from patient to patient. Some patients heal faster than others.

When will I be able to fully recover from the surgery?

You will be able to fully recover from the surgery within three weeks.

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