Canthoplasty

Specialty of Ophthalmology

What is canthoplasty surgery?

Canthoplasty surgery refers to several procedures that reposition the lateral canthus, which is the outer corner of your eyes where the upper eyelids meet the lower eyelids. The end results of canthoplasty surgery is generally a wider-eyed appearance, with the eyes more cat-eye in style (i.e. they slant slightly upwards). This procedure is performed using either local anaesthetic or intravenous sedation.

Why is canthoplasty surgery done?

This procedure may be carried out for either cosmetic or medical purposes and can create a almond / cat-eye shape or reduce the effect of droopy eyes (ptosis) or eye bags that occur with ageing. Canthoplasty may also be performed to correct a lower lid malposition or laxity caused by either trauma or previous eyelid surgery (blepharoplasty). 

What does canthoplasty surgery involve?

In canthoplasty surgery, the lateral canthal tendon is detached, shortened and re-attached to the lateral orbital rim. There are two main types canthoplasty surgery. The first is called a lateral canthoplasty. This achieves a ‘cat eye’ appearance. The second is called an epi-canthoplasty which involves the reshaping of the inner corner of the eyes. These procedures take between 1-2 hours, most frequently performed under local anaesthetic where the eye area is numbed. A special clear plastic shield will cover your eyeball, which is removed after the incisions are closed. The eye will then be dressed to protect the wound and reduce swelling.

How do you prepare for canthoplasty surgery?

After careful examination by a specialist where they will assess your eyes’ anatomy and treatment options, when you are admitted for the procedure the surgeon will usually begin by marking on the eyes with pen where the incisions will be made. Next anaesthesia will be administered. Local anaesthetic is most commonly used for this procedure.

Aftercare following canthoplasty surgery

Canthoplasty can be performed as a day case procedure, and you can generally return home the same day, but make sure someone can drive you home. You may feel some pain and discomfort following surgery, but over-the-counter painkillers can be used to manage this.

Alternatives to this treatment

Although it is not strictly an alternative, canthopexy is a less invasive technique that does not cut the tendons, but merely uses carefully placed sutures to tighten and stabilise the lateral canthal tendon. Hence, there is a quicker recovery time than with a canthoplasty. However, it is uncommon for a canthopexy not to accompany another form of lower eyelid surgery and is usually carried out in conjunction with this. 

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