What is canthopexy?

Canthopexy is an eyelid procedure that focuses on strengthening the lateral canthus (the outer corner of the eye), the tissue that connects the lower eyelid to the eye socket. Due to ageing, trauma or other factors, this tissue can weaken, leading to a sagging or drooping eyelid, a condition known as ectropion or low-hanging eyelids. This can cause not only a tired appearance but also functional problems, such as dryness of the eye and excessive tearing. Canthopexy is performed to correct these problems and give the eyelid a tighter, more youthful appearance without reshaping the entire eyelid.

Canthopexy is often performed in people who have a lower eyelid that has lost its firmness. It differs from canthoplasty, which is a more invasive procedure aimed at a complete reconstruction of the corner of the eye.

When is canthopexy needed?

Canthopexy may be needed for both functional and aesthetic reasons. Some of the main reasons to choose this procedure are:

Drooping eyelids (ectropion): as a result of ageing or trauma, the lower eyelids can sag and turn outwards, which can leave the surface of the eye unprotected and lead to dryness. Canthopexy helps to strengthen the lower eyelid and keep it in the correct position.
Correction of complications after a eyelid surgery: after a blepharoplasty, the lower eyelid can sometimes lose its support. Canthopexy can help to correct this and prevent further complications.
Aesthetic improvement of the eye shape: canthopexy can also be used to change or adjust the shape of the eyes, for example to create an almond-shaped eye or to lift the lateral canthus.

The canthopexy procedure

Canthopexy is a relatively simple procedure that is usually performed under local anaesthetic. Depending on the patient, the procedure can also be performed under sedation or general anaesthetic. It is often combined with other eyelid or facial procedures, such as a facelift or blepharoplasty.

Steps of the procedure:

Incision: the surgeon makes a small incision at the outer side of the eye, just along the natural crease of the eyelid. This allows access to the tissues that support the lateral canthus.
Strengthening the canthus: the lateral canthal ligament is carefully stitched to the bone of the lateral eye socket, or the tendons that support the eyelid are tightened. This helps to stabilise the lower eyelid and prevent sagging.
Stitching: once the eyelid has been brought into the desired position, the incisions are closed with fine stitches. These are removed after a short period or may be dissolvable.

The procedure itself usually takes less than an hour and requires just under a week of recovery time.

Recovery after canthopexy

Recovery after a canthopexy is generally relatively quick and not very demanding. Most patients experience mild swelling, bruising and discomfort around the treated area, but these symptoms usually disappear within a few days to a week. Recovery time can vary, depending on whether the procedure is performed on its own or combined with other procedures.

Some recovery guidelines are:

Cold compresses: applying cold compresses to the eyes can help to reduce swelling and bruising.
Eye ointments or eye drops: the doctor may prescribe lubricants or antibiotic ointments to prevent infection and keep the surface of the eye moist.
Limited activities: during the first week after the operation, patients are advised to avoid strenuous activities, such as sport or lifting, to minimise strain on the eye.
Protecting the eyes: wearing sunglasses outdoors can help to protect the eyes from bright light and dust while they heal.

Most patients can resume their daily activities within a few days, but full healing can take several weeks. The final result of the operation usually becomes visible once the swelling has completely gone.

Benefits of canthopexy

A canthopexy offers many benefits for people looking for a subtle improvement in the contours of their eyes, or who are dealing with functional problems such as drooping or outward-turning eyelids.

Strengthening of the eyelid: the procedure helps to stabilise the lower eyelid and prevents sagging, which gives better protection to the surface of the eye.
Subtle aesthetic improvement: canthopexy can give the eyes a more youthful and tighter appearance without making drastic changes.
Short recovery time: because it is a relatively minor procedure, the recovery time is short and the procedure itself places minimal strain on the patient.
Combination with other procedures: canthopexy can easily be combined with other facial procedures such as blepharoplasty or a facelift, for a fully rejuvenated appearance.

Possible complications of canthopexy

Although canthopexy is a safe and common procedure, there are risks involved, as with any operation. The chance of complications is small, but possible complications include:

Infection: as with any surgical procedure, there is a small risk of infection. This can usually be treated with antibiotics.
Irregular eyelid position: in some cases, the eyelid may be positioned slightly too high or too low after the operation, which can be corrected with a second procedure.
Scars: although the incisions are small and strategically placed, there is a chance of visible scarring, although this is rare.
Dry eyes: some patients may experience temporary dryness of the eyes, but this usually disappears over time.

Difference between canthopexy and canthoplasty

It is important to distinguish between canthopexy and canthoplasty, as these terms are often used interchangeably but describe different procedures.

Canthopexy is a less invasive procedure that focuses on strengthening the outer corner of the eye without a complete reconstruction of the eyelid. It provides a subtle lift and support of the lateral canthus and is particularly suitable for people who only need a slight correction.
Canthoplasty is a more extensive procedure in which the corner of the eye is reshaped. This is usually performed in patients with severe eyelid sagging or after trauma to the eyelid.

Both procedures are effective, but canthopexy is less complex and requires a shorter recovery time.