Canthopexy - Almond Eyes

Canthopexy is the procedure that is performed usually with a lower eyelid blepharoplasty to tighten the lower eyelid and for some people to create a more shaped almond eye. It can be performed as a procedure on its own in older people who have laxity to the lower eyelid. Performing the procedure with a blepharoplasty gives a better result than when it is done on its own.

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WHAT ARE THE DIFFERENT TECHNIQUES?

 

Different techniques can be used to perform a canthopexy. The common technique is where the outer corner of the eyelid or the lateral canthus is sutured to the outer wall of the eye socket to tighten the eyelid.  This can typically be done with a conjunctival blepharoplasty. Another technique is were the lateral canthus is tightened by creating a small strip or the outer aspect of the lower eyelid which is then pulled up and secured to the outer part of the eye socket. This is done with a traditional or skin pinch blepharoplasty. Both techniques are used to tighten the lower eyelid and can also be used to create an almond eye appearance.

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A lateral strip is best if a canthopexy is being performed without a blepharoplasty.  If a blepharoplasty is been performed in addition to a canthopexy then the suture technique can be used effectively. Both procedures can be performed under local anaesthetic or general anaesthetic. The choice of technique and anaesthetic used is decided following a discussion with your oculoplastic surgeon who can help you decide following an assessment and what may be best suited to you.

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WHAT ARE THE LIMITATIONS OF CANTHOPEXY?

 

One of the main difficulties your Oculoplastic surgeon, will need to assess is getting the tightness just right. Mr Ahmad Aziz is specialised in this surgery and can advise you if this is suitable for you in his Central London clinic. If the surgeon does not tighten the eyelid sufficiently, there can be residual laxity of the lower eyelid. If the eyelid is pulled too tight an entropion can occur where the eyelid pulls inward.  The success of the surgery depending on getting the tightness correct being not too tight and not too loose.

 

The lower lid can be significantly tightened especially when there is a degree of laxity. The amount of tightening required depends on how lax the eyelid is to start with and making sure the tension is correct at the end of the surgery. The amount of tension can be adjusted during the operation to make sure it is just right. If it looks too tight, the tension can be released on the operating table to give a natural look.

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ARE THERE ANY RISKS AND COMPLICATIONS?

 

With any eyelid surgery there is a small risk of to the globe. The specific risks to canthopexy tend to be a small scar if a lateral strip is performed that usually heals well. Few patients can develop webbing at the outer corner of the eyelid but this is less common. There is also the risk of the eyelid being too tight or too loose after the procure and a small risk of one eye looking slightly different to the other eye.

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HOW FAST DO YOU RECOVER AFTER CANTHOPEXY?

 

You can expect to have some bruising and swelling for 2 weeks following the surgery. At two weeks a person can usually go out and look reasonable in public although some swelling may remain. The amount of time it takes for the swelling to settle varies from person to person. There may also be a some eye watering as the eyelid heals.

 

As a canthopexy is performed on a small area of the eyelid the recovery can be shorter tat other types of eyelid swelling and many people can have a total recovery within 4 weeks although some take longer.

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WHEN WILL I SEE THE RESULTS?

 

Patients are generally happy following the surgery and most patients need just one canthopexy in their lifetime. That said however as we age the laxity of the eyelid can recur over the years and may need to repeat the procedure.  If the tension of the eyelid is not correct which can occasionally occur then an additional attempt to correct it may be required sooner.

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WHEN IS IT USEFUL?

 

If a patient is having a lower eyelid blepharoplasty the canthopexy is a good add on to tighten the eyelid at the same time. Most patients who have a blepharoplasty alone are happy with the results although some patients do come back wishing they had a canthopexy at the same time. In these cases the canthopexy is done on its own to make the lid tighter and give a better result.

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