Canthopexy is a specialized surgical procedure focused on the outer corner of the eye, the lateral canthus. Its primary goal is to stabilize and elevate the position of the lower eyelid. Compared to a canthoplasty, it is considered a less invasive technique because it reinforces existing eyelid support structures rather than fully reconstructing them. This method tightens the lower eyelid to address issues of laxity, providing both functional improvement and a subtle enhancement to the eye’s contour.
Understanding the Lateral Canthus
The term “canthus” refers to the point where the upper and lower eyelids meet. There are two in each eye: the medial (inner) and the lateral (outer). The lateral canthus is supported by the lateral canthal tendon, a band of fibrous tissue. This tendon anchors the eyelid tissues to the bone of the eye socket (orbit), maintaining the taut, horizontal position of the lower eyelid against the eye’s surface. Due to aging, gravity, or previous surgery, this tendon can weaken, causing lower eyelid laxity. This loss of firmness can cause the outer corner of the eye to droop or become rounded, which can expose more of the white of the eye below the iris.
Primary Reasons for the Procedure
Canthopexy addresses both medical conditions and aesthetic concerns arising from a weakened lateral canthus. Functionally, it corrects mild to moderate lower eyelid laxity, a common age-related change. Strengthening the supportive tendon helps the lower eyelid maintain contact with the eye, which is necessary for proper tear drainage and lubrication. The tightening action can also prevent or treat early-stage ectropion, a condition where the lower eyelid turns outward, or entropion, where it turns inward. Both of these malpositions can cause significant irritation, dryness, and excessive tearing.
Providing support after a lower eyelid blepharoplasty, a surgery to remove excess skin or fat, is another frequent functional application. This preventative measure helps ensure that the lower lid does not pull down following the removal of tissue. Aesthetically, patients seek canthopexy to improve the overall shape of their eyes. When the lower eyelid sags, the eye can appear tired, rounded, or even sad. The procedure subtly lifts the outer corner, helping to restore a more youthful, slightly upswept, or “almond” shape to the eye contour.
The Surgical Steps and Recovery Process
Surgical Steps
A canthopexy is typically an outpatient procedure performed using a local anesthetic, sometimes with light sedation, to ensure patient comfort. The surgeon makes a small, discreet incision near the outer corner of the eye, often hidden within a natural crease. This allows access to the lateral canthal tendon without the need for extensive tissue dissection. The core technique involves placing strong, internal sutures to reinforce and elevate the existing lateral canthal tendon. These sutures are anchored to the inside of the bony orbital rim, effectively tightening the lower eyelid and restoring its proper tension against the globe of the eye.
Recovery Process
Following the procedure, patients can expect temporary side effects, including swelling and bruising around the eyes. Applying cold compresses frequently during the first 48 hours is routinely recommended to help minimize this inflammation. Sleeping with the head elevated for several days also aids in reducing post-operative swelling. Non-dissolvable sutures are typically removed by the surgeon approximately five to seven days after the operation.
Most patients can return to light, non-strenuous daily activities within three to five days. However, it is generally advised to avoid vigorous exercise, heavy lifting, and any activity that significantly raises blood pressure for about two to three weeks to protect the healing tissues. During the recovery period, patients should also avoid rubbing their eyes and wear sunglasses to protect the sensitive area from wind and sun exposure.