15 Jul All you need to know about canthoplasty
Article summary
Sagging eyelids, tired eyes, asymmetrical eyes… If you are considering a surgical solution to correct the shape of your eyes, you may be interested in canthoplasty. This procedure, which is less well-known than traditional blepharoplasty, enables the shape and position of the outer corner of the eye to be changed precisely.
What is canthoplasty?
Canthoplasty is a surgical procedure that aims to change the shape or position of the lateral canthus, that is, the outer corner of the eye where the upper and lower eyelids meet. This technique can address eyelid laxity, enhance the harmony of the gaze, or correct asymmetry.
The procedure involves reinforcing or repositioning the canthal ligament that maintains the eye’s shape. Unlike a simple blepharoplasty, which removes excess skin, canthoplasty alters the very structure of the eye corner to achieve a more open, elongated look, or to correct certain misalignments.
Two main variants exist: lateral canthoplasty, which concerns the outer corner of the eye (the most common), and medial canthoplasty, which is rarer and treats the inner corner.
Who is this procedure for?
Canthoplasty is intended for individuals with natural or age-related eyelid laxity, malposition of the eye corner (ectropion or entropion), or those seeking a more youthful, elongated gaze. It is also performed to correct poorly healed eyelid surgery outcomes.
This procedure also appeals to some patients wishing to subtly modify the shape of their eyes for a more almond-like appearance, sometimes called “fox eyes” or “cat eyes”. However, it is important to have realistic expectations and to understand the limits of this technique.
Different techniques used
Lateral canthoplasty
It is the most common procedure. The surgeon cuts, tightens, and reattaches the lateral canthal ligament to the orbital bone to lift the outer corner of the eye. This technique provides a more open gaze and better definition of the lower eyelid.
The procedure is generally performed under local anesthesia with sedation or under general anesthesia, depending on the complexity of the case and patient preference.
Canthopexy
Less invasive than canthoplasty, this technique is limited to reinforcing or repositioning the ligament without cutting it. It is suitable for mild cases or as a preventive measure, notably after another eyelid surgery. Recovery is faster, but results may be less pronounced and less durable.
Medial canthoplasty
This rarer technique concerns the inner corner of the eye. It is necessary to correct significant asymmetries or congenital malformations. Its execution requires great expertise due to the proximity of the lacrimal canal.
Combined procedures
In some cases, several procedures are combined, such as lateral canthoplasty with lower blepharoplasty to address the eye shape and under‐eye bags, or canthopexy with a malar lift to elevate both the eyelid and the cheekbone.
The choice depends on the patient’s anatomy and their expectations discussed during the preoperative consultation.
Course of the surgical procedure
Preoperative consultation
A evaluation by the surgeon is mandatory before any procedure. The surgeon analyzes the shape of the eyes, the condition of the canthal ligament, the skin quality, the position of the eyelids, and any ocular pathologies.
Photos are taken for planning, and an ophthalmological assessment may be requested to verify the proper functioning of the eyelids. The surgeon explains the proposed technical options, with or without blepharoplasty.
The operation in the clinic
Performed on an outpatient basis under local anesthesia with sedation or under general anesthesia, the procedure follows several precise steps. The surgeon makes a discreet incision at the lateral canthus, performs a partial release of the ligament, repositions the outer corner, then secures it firmly to the orbital bone before suturing.
The procedure generally lasts between 1 and 2 hours depending on complexity. Some swelling and bruising are expected in the days following, entirely normal phenomena that gradually subside.
Results and recovery
Expected results
Canthoplasty alters the shape of the outer corner of the eye, corrects a drooping eyelid, and harmonizes the gaze. Results are visible after 2 to 3 weeks, but full stabilization and fading of scars take 2 to 3 months.
Often performed alone or in conjunction with blepharoplasty, it is also beneficial after trauma or surgery that has altered the eye’s shape.
Duration of effects
Its effects are long-lasting, between 7 and 10 years depending on skin elasticity, age, skin type, and lifestyle. The technique used and adherence to postoperative instructions also influence the longevity of the result.
Aesthetic and functional outcomes
It improves not only appearance but also eyelid stability, preventing sagging or inversion. For reconstructive purposes, it preserves proper eyelid closure and protects the cornea.
Examples of outcomes by case
| Indication | Expected results | Estimated duration |
|---|---|---|
|
Drooping gaze |
A more open and dynamic outlook |
8 to 10 years |
|
Asymmetry |
Improved facial symmetry |
7 to 9 years |
|
Post-traumatic correction |
Restoring the natural shape |
Varies from case to case |
A specialist consultation with Dr Bela is essential in order to adapt the treatment to each individual case. The aim is to guarantee a natural, safe and lasting result.
Risks, side effects, and contraindications
What are the possible risks?
Although controlled, canthoplasty carries risks such as postoperative asymmetry, infection, bleeding or hematomas, temporary blurred vision, or discomfort during healing. A touch-up may be necessary in case of an overly pronounced or artificial result.
Contraindications to canthoplasty
It is contraindicated in cases of severe dry eye, autoimmune diseases of the eyes or skin, local infections, healing disorders (such as keloids), or during pregnancy and breastfeeding.
A personalized evaluation by a specialist can confirm the indication and consider alternatives such as blepharoplasty in certain cases.
Cost of canthoplasty in Switzerland and coverage
The fees vary depending on the technique chosen, the practitioner’s experience, and the complexity of the procedure. The average price ranges between CHF 4,000 and CHF 8,000 and includes the consultation, surgical fees, anesthesia, and postoperative follow-up.
Basic health insurance generally does not cover this procedure if it is purely cosmetic.
Insurance coverage
Coverage may be considered if canthoplasty is necessary to improve a functional impairment, such as a reduced visual field or pathological eyelid malposition. A medical opinion and a detailed file are required for evaluation.
Financing and payment options
Some clinics may offer installment payment plans. The choice of surgeon should be based primarily on their experience, the quality of results, and safety, rather than the fee charged.
Choosing a specialist in Geneva: what you need to know
This procedure requires perfect mastery of eyelid aesthetics and function. In Geneva, it is essential to consult an eye specialist, familiar with the specifics of the canthal ligament and orbital anatomy.
Ophthalmologist or cosmetic surgeon?
If the objective is functional, an ophthalmologist specialized in oculoplastic surgery such as Cyrielle Bela is recommended. For a purely aesthetic purpose, an experienced eye surgeon may suffice. Ideally, a specialist combining both skills.
What to check before choosing
Before choosing a practitioner, it is important to verify their specific experience in canthoplasty, examine photos of similar cases, ensure they master modern techniques and can customize the approach to the patient’s gaze and anatomy. A clear explanation of the steps, side effects, and expected results is indispensable.
Consultation: a key moment
It allows you to ask all questions, assess ligament tension and eyelid position, and decide whether a canthoplasty alone is sufficient or needs to be combined with blepharoplasty. The surgeon carefully studies the shape of the eyes to propose an appropriate approach.
Clinics and safety in Geneva
Facilities specializing in eye treatments in Geneva emphasize safety, have experienced teams, and often offer innovative tools. The type of facility (private clinic or hospital) can affect anesthesia and postoperative recovery. Inquire during your first consultation with Dr. Bela.