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Canthoplasty & Canthopexy

Also known as lateral canthopexy, almond eye surgery, eye tilt surgery

Changes the tilt and shape of the eye opening. Powerful when indicated, disproportionately risky when done purely for aesthetics.

Evidence
Moderate
Typical cost
$3k – $9k
Permanence
Long-term
Timeline
Swelling resolves over 6–8 weeks; final position at 3–6 months.

US $3,000–9,000, often bundled with blepharoplasty.

How it works

Canthopexy tightens and repositions the lateral canthal tendon without detaching it; canthoplasty cuts and reattaches it at a new position on the orbital rim. Raising the outer corner creates a more positive canthal tilt and a more almond-shaped aperture.

How it's used

This is oculoplastic territory — go to a surgeon who does reconstructive eyelid work, not a general cosmetic clinic. Understand that purely cosmetic canthoplasty has a meaningful revision rate and that results can relapse. Be extremely sceptical of clinics marketing this as a routine "eye lift" add-on.

Trade-offs

In favour

  • One of the only ways to change canthal tilt
  • Can correct lower lid laxity and support other eyelid surgery
  • Meaningful change to eye shape when successful

Against

  • High revision and relapse rate for purely cosmetic cases
  • Small changes in position produce large changes in appearance
  • Poor outcomes are conspicuous and difficult to reverse
  • Often oversold by cosmetic tourism clinics

Risks and side effects

Read before deciding
  • Rounding or distortion of the eye corner
  • Lid malposition, retraction or ectropion
  • Asymmetry between the eyes
  • Relapse of the corrected position over months
  • Chronic dry eye and irritation
  • Scarring at the lateral canthus

Recovery

Week 1: swelling, bruising and a tight, pulled sensation. Week 2: sutures out, bruising fading. Weeks 3–8: shape settles and the initially over-corrected tilt relaxes toward the final position.

How good is the evidence?

Moderate
Real but modest effect, or small trials only.

Strong evidence in reconstructive and functional contexts. Purely cosmetic use has weaker outcome data and a notably higher revision rate.

Sources

Sources point to guideline bodies and literature searches rather than single papers, so they stay accurate as the evidence moves.

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