Extending the eye lengthwise to change it into a balanced, open-looking eye shape
Canthoplasty is surgery that widens the front end, the outer end, or the lower part of the eye to slightly increase the eye's width and height.
If you are looking into canthoplasty, we will show you the basic information at a glance first.
The criteria for choosing surgery according to eye shape are summarized in Causes of eyelid drooping and criteria for choosing surgery.
Medial canthoplasty widens the inner corner of the eye, lateral canthoplasty widens the outer corner, and lower canthoplasty widens the lower eyelid on the outer-corner side.
It is natural to be confused because the names are similar. It becomes much easier if you start by separating them according to which side is widened.
The front end of the eye is called the medial canthus (the inner corner of the eye), and the outer end is called the lateral canthus (the outer corner of the eye). Canthoplasty changes the position of these corners or the height of the lower eyelid to widen the opening between the upper and lower eyelids.
| Type | Area widened | Considered for these eyes | Limitations |
|---|---|---|---|
| Medial canthoplasty | Inner corner of the eye | An epicanthal fold covers the inner corner of the eye, and the space between the two eyes looks wide | If the eyes are naturally close together, they may look too close |
| Lateral canthoplasty | Outer corner of the eye | The eyes look short in width | Because of the bone outside the outer corner of the eye, the width that can be widened is small. It may rejoin |
| Lower canthoplasty | Lower eyelid on the outer-corner side | The outer corner of the eye looks tilted upward, and the eye looks narrow in height | If it is lowered too much, the white of the eye below may show or the eyelid may turn outward |
In some cases all three are done together, or they are done together with double eyelid surgery. Which one is needed is decided by examination.
When the distance between the eyes is wide, the eyes look less defined and closed-in. Medial canthoplasty is called 'medial epicanthoplasty' in medical terms, and the 'medial epicanthal fold' is the skin commonly called the 'Mongolian fold.' If the epicanthal fold is pronounced, the eyes look farther apart and give a closed-in feeling, and it also affects the shape of the double eyelid.
Medial canthoplasty removes the epicanthal fold, which allows the distance between the eyes to be adjusted to some degree and the double eyelid to be given a more open shape. Rediscovering what is hidden through careful analysis from many angles: this is canthoplasty at Face Plus.
※ This condition differs from person to person and can be determined after a close and careful examination.
It is surgery that releases the epicanthal fold covering the inner corner of the eye to reveal the front of the eye that had been hidden.
The epicanthal fold is a skin fold that covers the inner corner of the eye vertically. When this fold hides the caruncle (the pink tissue at the front of the eye), the space between the two eyes looks wider than it really is, and the eyes look short.
Here is a more detailed explanation of how the fold is released.
The epicanthal fold (medial epicanthal fold) is a skin fold that descends from the upper eyelid and covers the medial canthus, and it is considered a characteristic of East Asian eyelids[1][2]. Medial canthoplasty (medial epicanthoplasty) removes the fold and reveals the caruncle either by changing the direction of the skin with Z-plasty (a method of incising the skin in a Z shape to change its direction)[1], or by skin redraping (a method of releasing the skin and covering it again), in which the skin is lifted, the volume of the muscle underneath is reduced, and the excess skin is trimmed and laid back over[2]. Skin redraping aims to reduce the tension on the inner corner of the eye and thereby reduce scarring[2].
In simple terms — The skin fold covering the inner corner of the eye is released either by changing the direction of the skin or by covering it again.
Our medial canthoplasty method:
A Word from the Doctor
"In medial canthoplasty, never over-correct. It is actually safer to under-correct. Adding what is lacking is not so difficult, but undoing what has been overdone is far more complicated."
It is surgery that widens the outer corner of the eye outward to increase the width of the eye. However, the width that can be gained is not large.
We will start by showing you why the width that can be gained is not large.
Our lateral canthoplasty method and the measures to reduce re-narrowing:
It is surgery that lowers the lower eyelid on the outer-corner side slightly to increase the height of the eye and make the outer corner look less upturned.
Our lower canthoplasty method:
You can make a guess with a mirror, but whether canthoplasty is right is decided by measuring the distance between the eyes, the length of the eyes, and the elasticity of the eyelids.
You may have looked at your eyes in the mirror and guessed whether canthoplasty might be needed. We confirm that guess through an examination.
At the examination, we look at the following.
A Word from the Doctor
"When planning a treatment or surgery, I consider overall facial balance the most important thing."
The reason the eyes look small may lie not in canthoplasty but in weak eye-opening strength. In this case, see Ptosis correction (blepharoptosis correction) surgery information.
The area to be widened is marked while you sit upright, and after anesthesia, the skin and tissue at the corner of the eye are incised and sutured in the new position.
Since it may feel vague the first time, we have laid it out step by step.
| Step | Details |
|---|---|
| 1. Design | The direction and width of the widening are decided and marked |
| 2. Anesthesia | |
| 3. Incision and adjustment | In medial canthoplasty, the direction of the skin at the inner corner of the eye is changed; in lateral and lower canthoplasty, the skin and ligament at the outer corner of the eye are adjusted |
| 4. Suturing | Sutured with fine thread |
| 5. Going home |
Stitches are removed on day 7 after surgery. Swelling mostly goes down within a month, and the redness of the incision line fades over 2 to 3 months[3].
If you have work or an important appointment coming up, this is probably what you most want to know. We have written it by time point.
| Time point | Status |
|---|---|
| Day 7 | The stitches are removed |
| Within 1 month | Most of the swelling (over 90% in one study) goes down |
| 2 to 3 months | The redness of the incision line fades |
Stitch removal follows our clinic's standard (day 7), and the swelling and redness figures are based on a lateral canthoplasty study (Chae 2016).
The scar from medial canthoplasty is at the inner corner of the eye, so it may look red for the first few months. It fades over time, but in some people it becomes thicker[9][10].
| Activity | Time point |
|---|---|
| Washing your face | |
| Going to work | |
| Eye makeup | |
| Contact lenses |
The speed of recovery differs from person to person. If you have an important event coming up, please tell us in advance at the consultation.
We will start by explaining why you should rest for a few days after surgery.
Factors reported to be common in patients who developed bleeding behind the eye (in the orbit) after eyelid surgery include high blood pressure, taking aspirin before or after surgery, vomiting after surgery, and increased activity[11]. For this reason, strenuous activity is avoided for a few days after surgery.
Cold compresses, scar care (ointment, sun protection, tape), when to resume exercise, drinking, and saunas, and prescribed medications:
In some cases it can be corrected, but it is harder than the first operation. Revision surgery is considered only after at least 6 months have passed since the first operation.
We fully understand the wish to fix things as soon as possible when you are bothered by the result. Even so, we first watch how it heals.
Surgery that covers again the inner corner of the eye exposed by medial canthoplasty is commonly called medial canthoplasty reversal. Skin that has already been cut away or moved does not return to its original state. For this reason, reversal is done by rearranging the remaining skin. In one study of reversal after over-corrected medial canthoplasty (548 patients), 6% received further scar revision[10].
When lateral canthoplasty has rejoined, or when the lower eyelid sags after lower canthoplasty, we also look at the cause and decide after the scar has settled[7].
What is checked in revision surgery, and the methods, are explained in Revision eye surgery information.
Many people are concerned about a wide distance between the eyes. There are things that people considering medial canthoplasty should know.
— Dr. Park Jung Keun, Plastic Surgery Specialist · Face Plus Talk
Early medial canthoplasty was surgery that cut away the excess skin. After this kind of skin excision, however, excessive scarring often became a problem. A noticeable scar appeared in the lower part in particular, because there is excess skin in the upper part and a shortage of skin in the lower part. Therefore, the surgery should be done on the concept of using the excess upper skin to make up for the lacking lower skin.
Medial canthoplasty reduces the actual distance, while raising the bridge of the nose between the eyebrows gives a visual effect of narrowing the distance between the eyes. Therefore, only by accurately determining the cause, such as whether the skin of the epicanthal fold is truly excessive or the nasal bridge between the eyebrows is low, and then making the surgical plan, can a satisfactory correction be made.
Occasionally, someone who has had medial canthoplasty says the distance between the eyes still looks wide and asks for more medial canthoplasty, but this must never be done. The medial canthoplasty area becomes awkward, and the distance between the eyes stays the same.
There are things to evaluate in advance for medial canthoplasty. The distance between the eyes and the amount of the lacrimal lake must be examined closely. If the epicanthal fold is pronounced or the distance between the eyes is excessive, a good result can be obtained after surgery.
You can also gently pull with your finger to roughly predict how it will look after surgery. In medial canthoplasty, never over-correct. It is actually safer to under-correct. Adding what is lacking is not so difficult, but undoing what has been overdone is far more complicated. The scar from medial canthoplasty can be more noticeable than that from double eyelid surgery. You should know that side effects such as excessive scarring, asymmetry after surgery, and under-correction can occur.
To conclude, when the distance between the eyes is wide, the right method must be chosen according to the cause; forcing medial canthoplasty is never a good idea; and the height of the nasal bridge between the eyebrows should also be considered.
Our clinic's anesthesia method for canthoplasty:
If you are worried about anesthesia, please feel free to ask at the consultation.
Scarring, left-right differences, eyes looking too open, rejoining, changes in the shape of the outer corner of the eye, and exposure of the red inner tissue or the white of the eye may occur, and, rarely, there is bleeding that threatens vision.
This is information you must know before deciding on surgery, so we have written it out in full without shortening it.
A review (a paper that organizes and explains multiple studies in the literature) that sorted the complications of eyelid cosmetic surgery by time period listed corneal abrasion (scratching of the surface of the cornea) and retrobulbar hemorrhage (blood collecting behind the eye), which can threaten vision, within 1 week after surgery; malposition of the upper and lower eyelids, strabismus (misalignment of the direction of the two eyes), exposure keratopathy (the eye not closing fully, exposing the surface of the cornea), and epiphora (watering of the eye) at 1 to 6 weeks; and problems with eyelid height and contour, left-right differences, scars, and prolonged swelling after 6 weeks[6]. This review covers upper and lower eyelid surgery together and is not data on canthoplasty alone.
In simple terms — The problems we watch for differ depending on the time period.
Bleeding behind the eye is reported to occur most often within 24 hours after surgery, especially within the first few hours, and in some cases it occurred a few days later[11].
If something feels wrong after surgery, do not put up with it on your own.
Symptoms to have checked promptly
Outside clinic hours, do not wait: call 119 or go to the nearest emergency room.
Tell us at your next visit
During recovery, Dr. Park and the nursing team check your swelling, pain, and general condition together.
Yes. Typical examples are medial canthoplasty when the two eyes are naturally close together, and lower canthoplasty when the lower eyelid is lax. Criteria based on your health condition are checked at the consultation.
Surgery is not right for everyone right now.
Eyes with a lower eyelid that is horizontally lax, or that already show the white of the eye below, are prone to lower eyelid malposition after surgery[8]. People whose eyes are dry or whose eyelids are lax even before surgery may have a higher risk of dryness symptoms or conjunctival edema after eyelid surgery. There is also a report that fixing the outer corner of the eye during surgery was associated with a higher risk of conjunctival edema[13].
In plain terms
Please tell us about all medications you take and any conditions you have at the consultation. Even things that seem minor are fine to mention.
Yes, it does. A small scar forms at the inner corner of the eye, and for the first few months it may look red. It fades over time, but in some people it becomes thicker.
Because there is bone right outside the outer corner of the eye, the width that can be widened is small, and if the fixation is not suitable, the eye may narrow again. So we first measure the distance between the outer corner of the eye and the bone before deciding. The details are summarized in the comparison of the three types of canthoplasty.
In some cases it can be corrected, but it is harder than the first operation, and further scar revision may be needed. Revision surgery is considered only after at least 6 months have passed since the first operation.
In some cases they are done together. Whether to do them together is decided by looking at the distance between the eyes and the shape of the inner corners of the eyes. Double eyelid surgery is explained in the double eyelid surgery information.
If the skin was stitched, they are removed on day 7 after surgery.
Yes. Many patients come from countries with advanced medical care, such as the United States and Japan. Among overseas patients, about 60% are from Japan and about 30% are from the United States.
This links to a video on the Face Plus Plastic Surgery YouTube channel. View All FacePlus TV
These are surgeries and procedures often discussed together with this surgery during consultations. Whether to have them together is decided after an examination.
He personally consults on and performs facial aging treatments such as facelift, droopy eyelid surgery, and thread lift. The doctor personally sees you from consultation through recovery.
About the DoctorThe content of this page is general medical information provided in accordance with the Medical Service Act, and the effects and recovery time of surgeries and procedures may vary by individual. All surgeries and procedures can cause side effects, so please make your decision only after a thorough consultation with a plastic surgery specialist.
Facelift, droopy eyelid surgery, and thread lift: Dr. Park Jung Keun personally checks every stage, from consultation to recovery. Please schedule by phone or KakaoTalk, or leave a consultation request form.
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