Canthoplasty Before and After: What It Changes, and a Preview on Your Face

The corners of the eye are anchored by small tendons — the lateral canthal tendon at the outer corner, the medial at the inner. In a canthoplasty the surgeon releases the tendon, then reattaches it to the bone of the eye socket, tightened and often at a different height. That is what separates it from a canthopexy, which tightens the tendon without detaching it.

It is done for medical and cosmetic reasons. Cleveland Clinic lists lower lids that sag, turn outward (ectropion) or inward (entropion), eyes that do not close fully and injury among the medical ones; cosmetic reasons include tightening a sagging lid, evening out asymmetric corners and changing the tilt or shape of the eye. The American Society of Plastic Surgeons (ASPS) notes it is also marketed as "cat eye surgery", because it can lengthen the eye opening while lifting the outer corner.

It is performed under local or general anesthetic and, depending on what is done, takes from about 30 minutes to a few hours. It is frequently combined with lower eyelid surgery.

The same word covers operations that move the eye corner in opposite directions. Before comparing photos or quotes, it is worth knowing which one is being discussed.

Lateral canthoplasty

The version most people mean in the United States: the outer tendon is reattached tighter and usually higher, supporting the lower lid and changing the outer corner's angle. In East Asian cosmetic surgery, lateral canthoplasty often refers instead to lengthening the eye outward, which does little to the tilt.

Medial canthoplasty

Surgery on the inner corner. Reconstructive versions treat injury or an abnormally wide gap between the inner corners; cosmetic versions overlap with releasing the fold over the inner corner, covered on the epicanthoplasty page.

Lower canthoplasty

The outer part of the lower lid is lowered so more of the eye shows below the iris, making the eye look larger and gentler. It works against a lifted, angled look — and because it increases the white shown beneath the iris, lower lid position is the thing surgeons discuss most carefully with it.

Neither is better in general; they solve different amounts of problem. A canthopexy supports a corner that is already near the desired position, with a shorter recovery and lower risk. A canthoplasty can reposition the corner and is more durable, because the tendon is structurally reattached rather than held by sutures — ASPS describes it as offering more dramatic and lasting change with a higher risk profile and longer recovery. Surgeons generally use the smaller operation where it is enough.

If what you want is a lifted brow tail and temple rather than a moved eye corner, neither may be the relevant operation; the fox eye lift page compares the thread and brow-based routes.

"Bella eyes" is a social media nickname for a lifted, almond-shaped outer eye with a clear upward tilt. It is not a medical term, no surgeon offers a procedure by that name, and it says nothing about how any particular person's eyes came to look the way they do. The simulation on this page carries the name because people search for the look by it; the operation that changes the outer corner's position is a lateral canthoplasty.

Canthoplasty galleries are dominated by best cases, and the operation is one where the less flattering cases are the informative ones. When you look at canthoplasty before and after photos:

• ✓Look at the lower lid, not just the corner. A good result keeps the lower lid against the eye. White showing beneath the iris that was not there before (scleral show) is a result, not a lighting effect.
• ✓Check the corner itself. A sharp corner that has become rounded or webbed is a recognized problem and is easy to miss at thumbnail size.
• ✓Timing. The eye shape settles over one to three months. Photos at one week show swelling; photos at three to six months show the result.
• ✓Head angle and gaze. Chin down and eyes up lifts the outer corner in any photo; both frames should be straight on at eye level.
• ✓Which version. A lengthening canthoplasty and a lifting one look nothing alike. Ask which was done.

Canthoplasty before and after in men

The procedure is the same. What changes is how visible a strong upward angle is: on a face with a straighter, lower brow, an over-angled corner can read as operated on. Male canthoplasty results worth studying are the ones where you cannot quite say what changed.