Lower Eyelid Malposition - Lateral Tarsal Strip Canthoplasty

The lateral tarsal strip canthoplasty improves many lid malpositions. It is used to correct retraction (cicatricial or involutional) and ectropion. It is also a champion technique for elevation and tightening of the eyelid. It can be performed as a sole procedure or in conjunction with a midface lift. Although most canthoplasties can produce eyelid tightening, tarsal suspension allows elevation, retroplacement, and tightening even if the eyelid is under inferior-based tension.

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at-a-glance

Lower Eyelid Malposition - Lateral Tarsal Strip Canthoplasty

avg. recovery
7 weeks
permanence
Temporary
application
Not Applicable
surgical
Yes
cost
$0 - $1500

About the Procedure

A lateral tarsal strip canthoplasty can improve lower eyelid malposition by lifting the lower eyelid to improve aesthetic appearance and allow for better vision. An incision will be made in the outer corner of the eye, typically within a pre-existing wrinkle or crow's feet mark, between 8 to 10mm in length. The lateral canthal tendon is then excised between 6-12mm to effectively shorten the lower eyelid and improve eyelid laxity. Sutures are made within the tarsal strip and secured within a dense layer of vascular tissue around the eye. Alternative procedures to help correct lower eyelid laxity include steroid injection and massage for a non-invasive technique, as well as a canthopexy procedure. The canthoplasty procedure is typically preferred to the cathopexy as it is longer lasting and has a lesser chance of reoccurence. The best way to decide which procedure will work best for your individual needs is to speak to a board certified surgeon during an in-person consultation.

The goal of a lateral tarsal strip canthoplasty is to elevate the lower eyelid for better vision and cosmetic appearance.

Concerns

Lower Eyelid Malposition - Lateral Tarsal Strip Canthoplasty addresses concerns such as:

Recovery Notes

Superficial sutures are typically removed after 3-5 days however deeper tissue sutures must be kept in place for 8-9 days before removal. Patients should be mindful to not pull at their eyelids. If eyelid asymmetry is present 1 week postoperatively, the surgeon can soften the asymmetry through simple, in office stretching of the tarsal strip.

Ideal Candidate

The ideal candidate for a lateral tarsal strip canthoplasty is an older patient with lax, horizontally lengthened eyelids or patients who treat the eye area indelicately or frequently manipulate their eyelids (e.g. contact lens wearers and patients who require frequent instillation of eyedrops).

Not Recommended For

Lateral tarsal strip canthoplasty is not recommended for candidates with a large globe, shallow orbit, or hypoplastic malar eminence as diminished efficacy has been noted.

Side Effects

Side effects from lateral tarsal strip canthoplasty may include discomfort and bruising in the lids, infection, recurrence of the ectropion requiring further surgery, eyelid scarring, and granuloma formation which may settle by itself or need to be surgically removed.

Pros
  • Eyelid tightening
  • Eyelid elevation
Cons
  • Not permanent
  • Asymmetry
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