Abstract
Lateral canthal suspension is an essential component of lower eyelid surgery. Unfortunately, the lateral canthus is a complex and delicate anatomic structure whose position, appearance, and function can be difficult to maintain or recreate after surgery. This has made canthoplasty a somewhat confusing, intimidating, and controversial area of surgery for aesthetic eyelid surgeons. Early descriptions of the procedure were restorative in nature with an emphasis on correcting eyelid pathology (ectropion, retraction, etc.). Surgery involved lower eyelid disinsertion and shortening. While this lateral tarsal strip procedure is powerful, significantly improves eyelid position, and yields consistently excellent results, it can also alter the position and appearance of the canthus. In aesthetic eyelid surgery, the goal is to not to restore function, but rather to enhance appearance without disturbing function. This requires canthal procedures which support the eyelid but are less distorting of anatomy. A modified canthoplasty, in which the lower lid is reinforced to bone, without its disinsertion or shortening, or a canthopexy, where the orbicularis muscle is used to support the lower lid, can be performed to accomplish this goal. These procedures are not only less powerful than traditional canthoplasty but also simpler and quicker, and yield less postoperative complications. They are a necessary step in lower eyelid blepahroplasty surgery and can be mastered with experience.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Edergton Jr MT. Causes and prevention of lower lid ectropion following blepharoplasty. Plast Reconstr Surg. 1972;49(4):367.
Rees TD. Correction of ectropion resulting from blepharoplasty. Plast Reconstr Surg. 1972;50(1):1.
Levine MR, Boynton J, Tenzel RR, et al. Complications of blepahroplasty. Ophthalmic Surg. 1975;6(2):53.
Tenzel RR. Surgical treatment of complications of cosmetic blepharoplasty. Clin Plast Surg. 1978;5(4):517.
Neuhaus R, Baylis H. Complications of lower eyelid blepharoplasty. In: Putterman AM, editor. Cosmetic oculoplastic surgery. New York, NY: Grund Stratton; 1982.
McGraw BL, Adamson PA. Postblepharoplasty ectropion. Arch Otolaryngol Head Neck Surg. 1991;117:852–6.
Taban M, Douglas R, Li T. Efficacy of “thick” acellular human dermis (alloderm) for lower eyelid retraction. Arch Facial Plast Surg. 2005;7:38–44.
Nowitzki T, Anderson RL. Advances in eyelid malposition. Ophthal Plast Reconstr Surg. 1985;1:145.
Carraway JH, Mellow CG. The prevention and treatment of lower lid ectropion following blepharoplasty. Plast Reconstr Surg. 1990;85(6):971.
Shorr N, Goldberg R, Eshagian B, Cook T. Lateral canthoplasty. Ophthal Plast Reconstr Surg. 2003;19(5):345.
Fagien S. Algorithim for canthoplasty: the lateral retinacular suspension: a simplified suture canthoexy. Plast Reconstr Surg. 1999;103:2042–53; discussion 2054–2058.
Chong KK, Goldberg RA. Lateral canthal surgery. Facial Plast Surg. 2010;26(3):193–200.
Massry GG. Comprehensive lower eyelid rejuvenation. Facial Plast Surg. 2010;26(3):209–21.
Shovlin JP, Lemke B. Clinical eyelid anatomy. In: Bosniak S, editor. Principals and practice of ophthalmic plastic and reconstructive surgery. Philadelphia, PA: WB Saunders; 1996. p. 261–80.
Converse JM, Smith B. Canthoplasty and dacryocystorhinostomy. Am J Ophthalmol. 1952;35(8):1103.
Beard C. Canthoplasty and brow elevation for facial palsy. Arch Ophthalmol. 1964;71:386.
Anderson RL, Gordy DD. The tarsal strip procedure. Arch Ophthalmol. 1979;97:2192.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Massry, G.G. (2011). Managing the Lateral Canthus in the Aesthetic Patient. In: Massry, G., Murphy, M., Azizzadeh, B. (eds) Master Techniques in Blepharoplasty and Periorbital Rejuvenation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0067-7_17
Download citation
DOI: https://doi.org/10.1007/978-1-4614-0067-7_17
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-0066-0
Online ISBN: 978-1-4614-0067-7
eBook Packages: MedicineMedicine (R0)