One of the major complications of lower eyelid blepharoplasty is a retracted (pulled down) lower eyelid.  This leads to a change in the shape of the eye, a rounded outer corner to the eye, and sometimes a “wide-eyed appearance.” The goal of any cosmetic blepharoplasty is to improve appearance in a natural way – “NOT” to change ones look.

How can this be accomplished.  Firstly, performing surgery from the inside of the lid, “a transconjunctival blepharoplasty,”reduces the chance of an altered shape to the eye.  The surgeon must be well versed in this procedure to perform it correctly.  Next, a preoperative assessment of eyelid laxity (looseness), and excess skin must be made.

If the lid is loose, or if there is skin to be excised, the lid may need to be tightened for support.
The lid tightening procedure is called a canthoplasty. This procedure may be a necessary step in lower lid blepharoplasty to prevent altering the shape of the eye.  An off-shoot of the canthoplasty procedure is called a canthopexy.  This is also a lid tightening- just a less aggressive one.  It is indicated when the lid requires less support.

Canthoplasty surgery is a very specialized procedure which should only be performed by cosmetic surgeons with significant experience with eyelid surgery.  If performed incorrectly the results can be disastrous.  Before undertaking this surgery make sure the surgeon has experience in this area.

Dr. Guy Massry has specific expertise in canthoplasty and canthopexy surgery.  Please refer to his photo gallery, or below (left – before surgery, right – after surgery), for examples of lower lid blepharoplasty procedures which included canthoplasty and canthopexy.