As described earlier in this section, lateral canthoplasty is an aggressive surgical procedure designed to increase lower eyelid support by first disinserting and then reattaching the lateral retinaculum and canthal tendon at a higher level.
The operation is employed mainly in reconstructive and revision eyelid surgery but sometimes as an adjunct during transcutaneous lower blepharoplasty.
If overdone, canthoplasty can create a lower eyelid that looks pulled up at the outer corner, thereby changing the natural slant of the eye and narrowing the opening between upper and lower eyelids (the "palpebral fissure"). In most circles, this effect is considered a complication of surgery, namely an overcorrection.
Interestingly, there exists a group of Occidental (that is, of European descent) patients who specifically desire this very outcome to look (in their own words) either "more "exotic,"more Asian," or much less commonly, "more cat-like." Most oculoplastic surgeons receive several such requests each year. Few ever comply, but a persistent patient will always be able to locate another practitioner who is more willing.
Such "cosmetic canthoplasty" is mentioned here only to discourage its use.
The major downsides of undergoing canthoplasty are presented in these movies and will not be repeated here. It is not a procedure to be applied casually. When employed for the reasons discussed here, it more often creates an appearance that is "surgical" rather than "exotic."
And while all plastic surgery operations are a form of "body modification," this procedure takes the cake for surgery on the eyelids.
Canthopexy is occasionally used to achieve a similar sort of intentional upslant. Fortunately, canthopexy is weaker than canthoplasty and has less chance of maiming the eyelids permanently. Unless the operation is "needed," we discourage its use for this indication.
You might be interested to learn that there is yet a third form of canthoplasty known as "Asian canthoplasty." Described in our section on Asian eyelid surgery, its purpose is to make the eyelid opening look bigger.
That's right, bigger. Not smaller. Go figure.