Here's What You Need To Know About 'Designer' Eyes

Thanks to models and influencers like Kendall Jenner, Bella Hadid, and Emily Ratajkowski, the ‘fox eye’ trend is gaining popularity on social media and beyond, with people seeking to transform the shape of their peepers with everything from makeup to surgery.

Surgical options to achieve so-called ‘designer eyes’ include blepharoplasty (a.k.a. eyelid surgery), canthopexy, and canthoplasty — the latter two tighten the lower eyelid and lift the outer corner of the eyes. All three methods have long been used to treat and correct signs of aging, but younger patients are now turning to the procedures in a quest for a more pronounced almond eye shape.

To better understand the effects of canthopexy and canthoplasty specifically, we spoke to a board certified oculoplastic surgeon about the procedures and a trio of patients about their experiences and results.

Canthopexy vs. Canthoplasty

Both canthopexy and canthoplasty are surgical procedures that address the outer corner of the eye (a.k.a. the canthus) where the upper and lower eyelids meet. They can be performed for both therapeutic and cosmetic reasons, but they each have their own unique characteristics:

• Canthopexy: Sutures are used to stabilize and reinforce the lateral canthal tendon without altering the horizontal length of the eyelid or position of the canthus. Instead, it improves tone and helps relieve the look of sunken eyes.
• Canthoplasty: More invasive than a canthopexy, the surgery has the ability to alter the shape of the eye by correcting the canthal tilts that lead to sagging or drooping eyelids.

While canthoplasty is often used to refine or correct a previous eye surgery, canthopexy is often performed in combination with other procedures. “Canthopexy is a procedure where I tighten the lateral canthal tendon to give support to the lower eyelid,” says Jessica Lattman, MD, a board certified oculoplastic surgeon and clinical assistant professor of ophthalmology at NYU School of Medicine. “I often do it in conjunction with a lower eyelid blepharoplasty.”

As she explains it, the canthopexy helps to further refine the result of the blepharoplasty. “I do the canthopexy to preserve the shape of the lower lid, not change it,” she shares. “Sometimes if the lower lid is not supported after a lower lid blepharoplasty, it can get pulled down. Doing a canthopexy keeps the eyelid in place beautifully.”

Canthopexy & Canthoplasty Recovery

Because the procedures have differing levels of invasiveness, the downtown and recovery associated with them is different, too. Canthopexy is an outpatient procedure, and the recovery for a canthopexy alone is quick, Dr. Lattman says. “There are a few sutures in the outer corner of the eyelid, and those come out in about a week,” she explains. “Pain is very minimal, and bruising is usually minimal as well.” Needless to say, coupling a canthopexy with an additional procedure will impact the recovery timeline.

A canthoplasty, meanwhile, involves a bit more downtime and recovery. Most patients will experience bruising and swelling for seven to 10 days, around which time most normal activities can be resumed. Anything that causes eye strain should be avoided for the first few days after surgery, while contact lenses are typically discouraged for a few weeks post-op. Full healing can take a month or more.

Canthopexy & Canthoplasty Results

Canthopexy results are subtler than canthoplasty, though both have the ability to tighten the corner of the eye. After the bruising and swelling subsides in seven to 10 days, canthoplasty patients can generally expect to achieve a more almond-shaped eye. While the procedures can be performed as part of a more extensive rejuvenation surgery, they are now being sought by younger patients who are looking to replicate the elongated eye shape that is en vogue on social media.

Canthopexy & Canthoplasty Risks

As with all surgery, there is a level of risk involved. In the case of canthopexy and canthoplasty, the main concern is asymmetry. As such, Dr. Lattman and other surgeons often favor using these procedures for reconstructive purposes — as opposed to cosmetic rejuvenation. In younger patients, there may also be a need for revision surgery down the line as the skin loses elasticity with age. Finding a provider who is intimately familiar with the orbital area, like an oculoplastic surgeon, is of the utmost importance.

Alternative procedures that offer a similar ‘fox eye’ result for younger patients, include surgical and non-surgical brow lifts. Depending on the technique, the procedure can raise the outer part of the brow, lift drooping eyelids, smooth the forehead, and widen the eyes. Consulting with a board certified provider will ensure you receive the best treatment for your concerns.

Patient Perspective

We spoke to a trio of patients with different cosmetic concerns about why they chose a canthopexy or canthoplasty surgery, what the recovery process was like, and how they feel about their results.

Louise, 27, Memphis, TN

Louise, 27, underwent a cosmetic canthoplasty after seeing a local surgeon post about it on Instagram. The surgery refined her eye shape, which had long bothered her.

Alice, 39, San Francisco, CA

Alice, 39, decided on canthoplasty instead of a brow lift to subtly rejuvenate her eye area. While the results were subtle, they are exactly what she was hoping for.

Zac, 54, Chicago, IL

Zac, 54, chose to combine a canthopexy with a blepharoplasty to refresh his eyes, after no longer getting his desired results with injectables like Botox® and filler.

The Takeaway

Aesthetic trends come and go, but canthopexy and canthoplasty both offer the ability to strength and shape the corner of the eye for patients with both cosmetic and medical concerns. To avoid complications and unsatisfactory results, it is important to find a provider, like an oculoplastic surgeon, who specializes in the eye area.