How is Canthoplasty Performed?

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The type of technique a surgeon might use during a Canthoplasty depends on both the surgeon and the patient. Your surgeon will choose the technique that they are most talented with and the technique that will give you the best outcome possible. During your consultation, you can ask any questions you like about the surgical procedure and the surgeon will happily explain it to you.

What anesthetic is used?

Canthoplasty is usually performed under a local anesthetic and the type of anesthetic used will have been discussed previously. The surgeon will prep your eyes by using a marker to decide where the incision should be made. The area will be cleaned and you will usually be hooked up to an IV so that you can be given sedative medication. You will be given a local anesthetic that is usually injected into the area that the surgeon will work on. You will also be given a sedative because the operation is carried out whilst you are awake so the sedative will help you to remain calm and relaxed.

The surgeon will then begin the Canthoplasty. A plastic shield is usually put over the eyes to protect them.  A cut is usually made at the junction between the upper and lower eyelid and then the tendon underneath the eyelid is cut from the attachment bone. This tendon is called the lower canthal tendon and it will be divided and cut so that the tendon can be tightened.  It is then pulled into place so that it gives enough support to the eyelid and it is reattached with sutures. Any excess skin is also removed. The incision is then stitched and closed. The incision is made in the crease of your eyelids so that the scar should not be visible. A dressing will then be applied to the area to protect it.

Different techniques

There are other variations to this technique. One is that you can remove a chunk of the lower eyelid rather than tightening the tendon. The edges where the chunk has been removed are then stitched together which is known as a full thickness horizontal resection. This can be effective in patients and it is a much simpler approach but it may cause the eye to retract downwards if you have very prominent eyes or have a poor rim/cheek bone support.


You will then enter a recovery phase, where you will be monitored for the next two hours and the anesthetics will start to wear off. You may feel nauseous or cold from the anesthetic but these side effects are temporary and should subside. You will be able to go home after this time frame but you will need someone to drive you home because the sedative may not have fully worn off. Your recovery from surgery should not take very long because it is such a small procedure and you should be able to return to your normal routine two days after the operation.

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