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.
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.
The AEDITION: Why did you decide to have a canthoplasty?
Louise: I had a canthoplasty after seeing it on Instagram. I know it sounds weird to pick a surgery based on something I saw on social media, but it happened. I’d been unhappy with how my eyes looked literally for years, so I decided to look into it properly after seeing a post about the procedure by a local surgeon. I went for a consultation and was told I would be a good candidate. We discussed some other options, but this was the one I wanted.
The AEDITION: Are you pleased with the results?
Louise: Yes, I’m pleased with how it looks. It’s a few months after the procedure, and it certainly took a little time for me to adjust to it. Now I love how my eyes look. I do know that I might have to have the same surgery again or maybe another procedure to maintain the results, depending on how I age.
The AEDITION: Do you have any advice or tips for the recovery process?
Louise: Like with any medical procedure, follow all the instructions you’re given. I made sure to ask for my surgeon’s advice when it came to covering up residual bruising. I made sure I checked what makeup I could wear. I took in my usual makeup bag in case there were any ingredients I needed to check for. Other than that, I used more ice than I thought I would, so I would suggest buying a couple of bags of ice for that, too. Be prepared to rest up. I got myself a whole bunch of series queued up on Netflix and just spent a week off work relaxing while I let myself heal.
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.
The AEDITION: What led to you to have the surgery?
Alice: I’d been hesitating about having some rejuvenation work carried out for a year, and I was conscious of not having a look that was overly ‘done’ — at least not yet! But I was noticing some crow’s feet and general sagging in my eye area. That was the only area I couldn’t get to be the way I wanted to with non-invasive treatments. My surgeon and I discussed a brow lift as an option, but I didn’t want to go in too much too soon, so I opted for canthoplasty instead.
The AEDITION: How was your recovery?
Alice: It was pretty straightforward. I took a couple of weeks off work because my job is client-facing, and I didn't want to have the stress of needing to cover up any bruising or anything like that. The bruising was a lot less than I had anticipated. My surgeon told me it should be minimal, but, for some reason, I thought his minimal and my minimal would not be the same. On the whole, it wasn't bad. I had some pain on the first day after the surgery that became discomfort once I took meds. The pain certainly isn’t bad enough to warrant putting off having the procedure based on that alone.
The AEDITION: Are you satisfied with the results of the procedure?
Alice: It’s given me the result I was hoping for. I had some friends say they were expecting something more drastic, but, honestly, it wasn’t what I was looking for. I was pleased it looks natural. It’s given me a bit of lift, and it’s been just what I needed for now. I’ve always envisaged having more surgery as I get older, so I wasn’t put off by the prospect of having to have further procedures to maintain the results. I will likely have a brow lift in the next five or so years regardless. If someone is considering having the procedure but isn’t sure if this is the right eye-area procedure for them, you need to decide if you’re looking for a noticeable change or if you’re happy with something more discrete for now.
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 AEDITION: Why did you choose to have surgery?
Zac: I had a combined canthopexy and blepharoplasty to reduce signs of aging. I’d had some fillers and Botox® in the past, but I struggled to address that area without something a bit more invasive. I spoke to my surgeon about my options, and we came up with this treatment plan, which worked out really well.
The AEDITION: How was your recovery?
Zac: Of course it was more intense than having injectables. There was a decent amount of swelling for the first few days, and I did have some bruising. I had been told that was possible, so I expected it. In terms of pain, it was managed very well by my surgeon and his team. I was given drugs and clear instructions on how to manage any pain or discomfort before being sent home.
The AEDITION: Are you satisfied with the results of the procedures?
Zac: I really am. We kept the result natural looking. I had one colleague, who wasn’t aware I had gone in for the procedure, try to figure out what was different about me when I came back into work after my recovery. That’s just what I was hoping for. It’s a big change to me, but, to other people, it’s barely noticeable. To me, that’s a good indicator of a natural-looking result.
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.
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