top of page

Canthopexy / Canthoplasty

What are canthopexy / canthoplasty?

Canthopexy and canthoplasty are surgical procedures that can be performed in conjunction with (upper blepharoplasty or lower blepharoplasty) cosmetic eyelid surgery or as part of reconstructive surgery when the corner of the eyelid needs to be supported and strengthened.

A canthopexy or canthoplasty can help tighten the eyelids to prevent looseness or sagging especially after lower eyelid surgery. These procedures can also be used to change the shape of the eye from a more rounded appearance to more of an almond shape.

A canthopexy is less invasive and requires 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 supports the outside corners of the eyes and minimizes the risk of eyelid malposition after lower eyelid surgery.


A canthoplasty is more invasive than a canthopexy as it involves cutting through the orbicularis oculi muscle, detaching the lateral canthal tendon from the bone at the side of the eye. The eyelid may then be shortened and the lateral canthus is reformed and repositioned at the desired height and to achieve the desired degree of eyelid tightness. A canthoplasty may be needed in the setting of eyelid malpositions (ectropion or entropion), to change the shape of the eyes, or for eyelid reconstructions.

Commonly asked questions

What should I look for when choosing a surgeon?

Selecting the right cosmetic surgeon is a choice that you live with for years, if not your entire life. A successful procedure will make you feel more like yourself and give you greater confidence for years to come. On the other hand, selecting the wrong surgeon increases your chances of having poor results, which can lead to additional costs, time, and heartache.

When choosing your surgeon, there are a few key points to keep in mind:

  • What credentials should my surgeon have? Making sure that your doctor has received the right training focused on your issue. General plastic surgeons work on the entire body, and facial plastic surgeons perform work on the entire face. Dr. Liu is an Oculoplastic Surgeon, and completed an ASOPRS fellowship, and is therefore one of the most highly qualified oculoplastic surgeons in North America. When you are having surgery done near your eyes, you want to make sure that you have a surgeon that was trained in the eyes, and general and facial plastic surgeons typically have inadequate training in this area.

  • Ask detailed questions. Make sure that your surgeon answers all of your questions clearly and is willing to spend the time with you to address all of your concerns. A physician that cannot give a clear answer as to how many of a particular procedure they have performed or how their training qualifies them to perform a procedure should be chosen with care.

  • What do other patients say? While a referral from a friend or colleague can be helpful in narrowing down a physician search, it is important to try and get a well-rounded view of the physician. Look online at their reviews on websites such as,, and on Google and Yelp. Getting the full picture of other patients’ experiences with a physician can be helpful in putting your interaction with the doctor into the correct context.

What kind of anesthesia is used during a canthopexy or canthoplasty?

A canthopexy or canthoplasty can be performed using local anesthesia in Dr. Liu’s procedure room or may be performed at an off-site surgery center for additional sedation. Only in very rare cases would general anesthesia be used.

How much does a canthopexy/canthoplasty cost?

It is difficult to provide pricing before a patient has had a consultation with Dr. Liu. The cost of a procedure can vary depending on what a patient needs and what the surgery will entail. More importantly, many patients come to Dr. Liu believing that they need a certain procedure, only to find out during the consultation that a different procedure will provide a better outcome. 

How does Dr. Liu perform a canthopexy or canthoplasty?

Dr. Liu will make a skin incision by the outside corner of the eye and place it in an area where scarring from the procedure will be less visible. Once the incision is made, she will identify the lateral canthal tendon and adjust it using specialized surgical instruments including microsurgical instruments. Dissolvable sutures will be placed underneath the skin to support the lateral canthus and achieve the desired restructuring and reshaping of your eyelids.

The specific techniques that Dr. Liu uses will be selected based on your needs. Because Dr. Liu has such specialized training, she has access to a number of techniques that are not utilized by most other doctors, and she will tailor these techniques to get the best outcome for you.

How long does the procedure take?

A canthopexy or canthoplasty typically adds about half an hour to an hour onto your surgery.

Does a canthopexy or canthoplasty scar?

A canthopexy or canthoplasty will have scars on the outside corner of the eyelids and they will be placed in an area that is less visible once healed. Non-specialized surgeons typically have results with more visible scarring.

Are there any risks to a canthopexy or canthoplasty?

Eyelid surgery is generally a very safe procedure. When considering any eyelid surgery, it is important to inform your surgeon of any abnormalities of your eyes, vision, or your general medical health. 

It is important to remember that while all surgery carries some risks, even when performed by the most highly trained surgeon and at the best facilities. Below are some of the more common risks associated with eyelid surgery:

  • Pain

  • Swelling

  • Scarring

  • Infection

  • Excessive tearing

  • Adverse reaction to anesthesia

  • Dryness or burning of the eyes 

  • The formation of whiteheads, or milia, that appear after suture removal; typically, the surgeon can treat these post-operatively

  • Difficulty keeping the eyes closed while sleeping; though temporary for most individuals, this particular complication has become permanent in others

  • On occasion, individuals have also reported experiencing blurred or double vision, but in most cases, these complications subside in a few days

The likelihood of serious complications arising from the procedure is typically influenced by both the surgeon’s skill as well as the patient’s individual response to the eyelid surgery. Certain severe risks or complications can be avoided by cooperating fully and completely following your surgeon’s instructions. With patience, a willingness to cooperate, and a qualified surgeon, the complications of eyelid surgery and any associated risks can be dramatically reduced.

What should I expect after surgery?

Surgery should be scheduled for a time when you can relax for at least 1-2 weeks. It is important to avoid any strenuous activity, heavy lifting, or bending down during this time to avoid complications and to promote the best healing. It is also important to avoid taking any blood thinning medications around the time of surgery. If you are on a blood thinning medication due to a specific medical condition, you will need to discuss this with Dr. Liu and your primary care physician prior to stopping any medication. Dr. Liu’s staff will review a list of common medications, supplements and vitamins that can cause your blood to be thinner.

Please note that Dr. Liu expects to see patients back in the office a few days after a procedure to ensure that the healing process is going as expected and that you are on track for a good result. Do not plan any travel immediately after your procedure.

Dr. Liu is Excellent! I chose Dr. Liu because of her extensive experience with surgical eye procedures, and because she is specifically trained in eye anatomy and eye surgery. Dr. Liu was amazing! She answered all my concerns and thoroughly explained everything to me prior to the procedure and even though I was awake, Dr. Liu’s calm and reassuring presence made me feel perfectly at ease during the relatively painless procedure. My recovery went quickly and smoothly and I am so pleased I chose Dr Liu.

San Clemente

Dr. Liu is the top rated oculoplastic surgeon in Orange County.

Click here to read more patient testimonials.

bottom of page