Canthopexy

Canthopexy is a procedure used to tighten the lower eyelid and is usually performed with lower lid blepharoplasty. It can also be performed by itself in an older person who has a very lax lower eyelid. While a canthopexy can be performed by itself, performing it with a blepharoplasty makes the blepharoplasty look better overall.

TECHNIQUES

There are a number of techniques that can be used when performing canthopexy. The first one is a standard technique where the lateral canthus or the lower lid is sutured up to the lateral part of the orbital wall. The second technique is a lateral strip where the surgeon takes a strip of lower lamella and pulls it up. While these are different techniques, they are all focused on accomplishing the same thing which is the tightening of the lower lid.

Many patients ask if one technique is more advantageous than the other technique. It all depends on what the procedure is trying to accomplish. A lateral strip is probably more advantageous if the surgeon is doing canthopexy by itself. If the surgeon is doing a lower lid blepharoplasty along with it, the standard technique compacted into the periosteum connective tissue covering the bones of the body works really well. It is decided on a case by case basis.

The procedure can be performed under a general or local anesthesia. The choice of anesthesia depends on the preference of the individual surgeon.

LIMITATIONS

One of the main limitations is that the surgeon has to get the tension or the tightness correct. If the doctor does not pull tight enough, there can be some laxity of the lower lid. There can also be an entropion of the eyelid where the eyelid pulls inward if it is pulled too tight. In general, “the meat of the operation” is making sure the surgeon gets the right tension on the lower eyelid.

The lower eyelid can be tightened pretty significantly. The doctor can take a person with a significant amount of laxity and tighten the lid up. There really is not a limitation on how much tightening can be done on the patient as long as the doctor makes sure to get the tension correct. If the tension is not correct, it will look odd and not look as aesthetically pleasing as it should. This is a problem that can normally be detected right away so, if it looks too tight, it can be redone while the patient is on the table.

RISKS AND COMPLICATIONS

Patients should be aware of the fact that anytime there is an operation around the eye or the globe, there are always going to be risks to the globe. In general, specific risks to canthopexy are very limited. Other than having too much or too little tension on the lower lid, there really are not any complications that are associated with the procedure.

RECOVERY

When it comes to the recovery process, patients should expect to be bruised and swollen for a week or two. However, at the 10 day to 2 weeks mark, a person can go out in public and look pretty good to the average eye. In general, it is the first week that is normally pretty bad for the patient in terms of bruising and swelling as well as eye watering.

Patients tend to heal really well from canthopexy because it is a very small area that is being operated on. Overall, the recovery takes a total time of less than a month.

RESULTS

Patients generally do not need any kind of touch-up procedure after a canthopexy. One canthopexy during a lifetime is all a person really needs to have performed. There can be cases where the surgeon did not get the tension correct so the patient might need a touch-up. It should be noted that most people do not get canthopexies until later in life when they are between their 50s and 70s. That is a big reason why they usually need just one procedure.

FINAL THOUGHTS

If there is a lot of droopiness or saggy and loose skin, a canthopexy can still be performed. If the patient is not happy with the results, the procedure can be redone to enhance the results. There can be times when a blepharoplasty is done without a canthopexy and the patient will come back to the doctor wishing they had also done the canthopexy. In that case, the canthopexy can be performed during a follow-up procedure to make everything look better.

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Robert Heck, MD in Upper Arlington, OH