Canthoplasty is a specific eyelid surgical procedure aimed at tightening or suspending the lower eyelid. It is both a reconstructive surgery (for eyelid malposition – i.e. lid turns out – ectropion, or lid turns in – entropion), and a cosmetic surgery (to support the lower eyelid during blepharoplasty).
Traditional canthoplasty has been reconstructive in nature and has involved releasing the lower lid from its attachments to bone, shortening it, and the re-securing it to bone. This is an excellent operation for patients with eyelid problems (as mentioned above); however, it can be a frustrating procedure for patients seeking cosmetic eyelid surgery (blepharoplasty). This is because such disruption of the lateral canthus (where the outer part upper and lower eyelids meet) can lead to symptoms such as pain, tenderness, tightness, mal-alignment of the two canthi from one eye to the other, webbing of the canthus and a change in the shape of the canthus (canthal angle becomes rounder or too narrow).
An option in cosmetic patients to avoid these potential problems is what we call a closed canthoplasty. This is a canthoplasty without cutting the canthus. This is performed by making a small incision in the outer upper lid crease (where a line or crease already exists) and accessing the lower lid for suspension through this point. This procedure suspends the lid without altering the canthus externally. While this may not be ideal for reconstructive cases – it is especially beneficial for cosmetic eyelid surgery (blepharoplasty).
Closed canthoplasty is an advanced surgical technique. It should only be performed by an eyelid specialist or a surgeon who has advanced training in eyelid surgery. Please do your research on this and consider the option before proceeding with traditional open canthoplasty during cosmetic eyelid surgery (lower eyelid blepharoplasty)
