9001 Wilshire Blvd, Suite 305, Beverly Hills, CA 90211


Published on June 30, 2015



As a result of the natural aging process, environmental factors (i.e. unprotected sun exposure), and lifestyle choices (i.e. smoking), our facial skin loses elasticity over time, contributing to undesirable sagging/drooping of the lower eyelids and the development of prominent under eye bags. These unwelcome aesthetic changes can significantly age one’s facial appearance and create the appearance that one is perpetually tired or unhappy.

Both canthoplasty and canthopexy:

  • Are surgical procedures that can be performed in conjunction with cosmetic eyelid surgery or as part of a reconstructive surgery when the corner of the eyelid needs to be supported and strengthened (for example when pre-operative assessment demonstrates lower eyelid sagging, drooping, and under eye bags).
  • These procedures are not primary aesthetic procedures. For example, canthal surgery alone is unlikely to make sufficient aesthetic difference to be worthwhile on its own unlike upper eyelid or lower eyelid surgery.
  • Can effectively contribute to a refreshed and rejuvenated appearance when performed correctly, by an experienced oculofacial surgeon, such as Dr. Steinsapir.
  • Can be used to treat the medical condition known as eyelid malposition (i.e. ectropion and entropion),which occurs when the lower eyelid is turned out or in, respectively, resulting in the eye becoming exposed, dry, and vulnerable to corneal abrasions, infections, or scleral show (excessive white showing beneath the iris).
  • Is almost always a necessary component of lower eyelid reconstruction after unsatisfactory lower eyelid or midface surgery.


While in some cases, these terms are mistakenly used synonymously, the techniques involved when performing canthopexy and canthoplasty surgery are markedly different:


  • Canthoplasty surgery focuses on the outer corner of the eye where the upper and lower eyelids meet (a.k.a. the lateral canthus). For most individuals, this junction should be slightly above the medial canthus (where the upper and lower eyelids meet near the nose), to produce a positive canthal tilt, an almond shaped eye, and a firm, smooth lower eyelid.
  • Canthoplasty is a more invasive procedure than canthopexy. It involves cutting through the orbicularis oculi muscle, detaching the lateral canthal tendon from the bone at the side of the eye socket, and shortening the lateral canthal tendon. The internal structure of the lower lid (tarsus) is then pulled over and re-attached to the lateral orbital rim at the appropriate height (often a small amount of skin is also trimmed at the time of surgery).


  • This less invasive eyelid surgery entails the meticulous placement of sutures to tighten and stabilize the lateral canthal tendon and orbicularis oculi muscle without detaching or reconstructing the tendon. This technique serves to support the external corners of the eyes and to minimize the risk of eyelid malposition after lower eyelid surgery.
  • Canthopexy is performed with local anesthesia or IV sedation in an outpatient setting and is almost always performed as an ancillary technique in conjunction with other eyelid procedures.
  • In many cases, canthopexy is performed in conjunction with lower blepharoplasty (lower eyelid lift) to create support. Almost all other situations require a more invasive lateral canthoplasty to accomplish the goal of correcting changes in the lateral canthal angle that blunt the angle or make it look more round and less almond shaped.

In order to determine whether canthoplasty or canthopexy is appropriate for your specific goals, Dr. Steinsapir will carefully analyze the anatomy of your eyelids, as well as your facial structure as a whole. This enables him to accurately diagnose the underlying structural causes of the lower eyelid sagging, drooping, and/or under eye bags and decide upon the optimal course of treatment.

If you are interested in learning more about canthopexy, canthoplasty, or any other eye enhancement surgery, please contact Dr. Steinsapir’s office today. You will receive a personalized treatment plan that is designed to create subtle enhancements that accentuate your unique facial structure and restore a more youthfully refreshed appearance to your eyes.

To learn more about procedures and treatments performed by Beverly Hills | Los Angeles Oculofacial Plastic Surgeon, Dr. Kenneth Steinsapir, contact us at 310-274-7422

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