Am I a Candidate for Canthopexy/canthoplasty, Ptosis Repair or Blepharoplasty?
Although I have monolids, my main problem has always been my droopy outer corners of
my eyes.
Can it be fixed with canthoplasty/canthopexy, a ptosis repair or blepharoplasty?
Thank you for your question!
Clearly, you've been doing a lot of research and you're using terms that are typically
used by surgeons.
So you're asking, canthoplasty or pexy, ptosis repair or blepharoplasty and you refer to
your eyes as monolids and you want to know, because your outer corners have always been
low, what are the things you should do.
Well, the reality is, although your photo is helpful, it cannot replace a full physical
examination.
So let's understand at least the terminology that you have question about and what are
the ways we figure out the right treatment plan for someone like yourself.
First of all, when you look at the outer corners of the eyes, the position of the outer corners
is based on an insertion of tendon called the lateral canthal tendon and it goes into
the inside of the bone of lateral orbital rim and that position is attached directly
to the bone.
So, when I do a procedure and typically it's very often for a reconstructive for patients
who had complications of lower eyelid surgery where the eyelids are pulled down, I do something
called drill-hole canthopexy.
Now, what I'm doing is essentially attaching whatever attachments the lower eyelid has
and drilling holes into the bone and re-attaching the eyelids to the bone using those drill
holes mimicking what nature would have created.
Now, it can be done for cosmetic reasons as well but we have to understand that the procedure
for the outer corner has many factors having to do with the volume of the socket, the projection
of the frontal bone, the upper part of the rim of the orbit, the lower orbital rim.
So there are many factors.
So when we talk about enhancing the outer corner, there's a limit on how high you can
make that outer corner.
The other part of the equation is how much of that fold kind of obstruct the appearance
of the outer corner.
Cosmetic blepharoplasty which is the most common procedure that we perform, in many
patients who have a lot of hooding, if you lift up the skin and you look at the eyes,
very often, the eyelid corner actually looks higher once the hooding is reduced.
So we kind of have to look at you with the eyelid skin rolled inward to see what your
thoughts are about the outer corner position.
Now the question about ptosis, the specific question has to do with the position of the
eyelid margin and the pupil.
So, very often people who have a lot of hooding above their eyes or have a physical weight
over their eyes it creates something called a pseudoptosis where the eyelid can appear
droopy or once tissue is elevated then the eyelid position becomes a little bit higher.
All these are factors that affect the plan based on your ultimate outcome or desire is.
This is a very subjective concern.
So what might be the advice that you will be getting out from all the different options
really depends on what would really make you happy.
So if you want the outer corner lifted physically then you're talking about a canthopexy type
of procedure.
If you're looking about a double eyelid procedure then you're looking at a blepharoplasty or
Asian eyelid procedure.
So at this point, the question that you are asking really requires a one-on-one consultation.
So I recommend that you seek out qualified cosmetic surgeons who can offer you the options
and spend some time with you that you need to really understand what your outlook will
be once the procedure is done.
Unfortunately, as a specialist, I get to see a lot of patients who are unhappy with the
results when they had their surgery done elsewhere and once I listen to them, it always sounds
like it had to do with communication.
That the doctor did what they intended to do but unfortunately, what the patient wanted
was not being heard and very often the actually ended up with more surgery than they wanted
or needed and unfortunately, miscommunication occurs and the results after the surgery is
completed is very difficult to reverse.
So I guess the message there is make sure you spend time and communicate and you are
clear about what you're desired outcome will be.
And so that with those questions addressed, I wish you the best of luck and thank you
for your question!