Canthoplasty vs Canthopexy: What’s the Difference?

Canthoplasty vs Canthopexy: What’s the Difference?

Canthoplasty and canthopexy are both eye corner procedures that focus on the outer corner of the eye (lateral canthus), but they are not the same surgery. The difference lies in how invasive the procedure is, how much structural change is made, and what problem it is meant to solve.

Understanding this distinction is essential, because choosing the wrong procedure can lead to overcorrection, unnatural eye shape, or unnecessary revision.

What Is Canthoplasty?

Canthoplasty is a reconstructive eye corner surgery.

It involves:

• Cutting and releasing the lateral canthal tendon
• Repositioning or reshaping the outer eye corner
• Re-fixating the tendon to a new position

Because the structure is fully adjusted, canthoplasty can change the shape, angle, and length of the eye.

What Canthoplasty Is Used For

• Drooping outer eye corners
• Downturned or sad-looking eyes
• Horizontal eye enlargement
• Significant eye shape correction
• Revision of previously overdone eye surgery

This is the procedure commonly referred to in Korea as lateral canthoplasty.

What Is Canthopexy?

Canthopexy is a supportive tightening procedure, not a shape-changing surgery.

It involves:

• Tightening and reinforcing the existing canthal tendon
• Anchoring it without cutting or fully releasing it
• Preserving the natural eye corner anatomy

Canthopexy focuses on stability and support, not visible enlargement.

What Canthopexy Is Used For

• Mild eye corner laxity
• Preventing drooping after lower eyelid surgery
• Early aging changes
• Supporting the lower eyelid
• Reducing risk of ectropion (lid pulling down)

It is commonly performed as a preventive or adjunct procedure.

Key Differences at a Glance (Explained in Words)

Degree of Change

• Canthoplasty: Structural change and eye shape modification
• Canthopexy: Subtle tightening with minimal shape change

Invasiveness

• Canthoplasty: More invasive, tendon is cut and repositioned
• Canthopexy: Less invasive, tendon is tightened and reinforced

Visual Impact

• Canthoplasty: Can noticeably lengthen or lift the eye
• Canthopexy: Usually not visibly obvious

Risk Profile

• Canthoplasty: Higher risk if overdone (round eyes, scarring)
• Canthopexy: Lower risk, mainly supportive

Why Korea Is Especially Careful With Canthoplasty

In Korea, canthoplasty has a mixed reputation because:

• Over-aggressive canthoplasty can cause unnatural eyes
• Poor technique may lead to visible scarring
• Excessive lengthening can distort facial harmony

As a result, many experienced Korean surgeons:

• Recommend canthopexy instead of canthoplasty in mild cases
• Use very conservative canthoplasty only when truly necessary
• Combine canthopexy with other eye surgeries for support

This cautious approach is why Korean eye surgery often looks more natural.

Which One Do You Actually Need?

You may need canthoplasty if:

• Your outer eye corner droops noticeably
• You want true horizontal eye enlargement
• You need correction after previous surgery
• Structural repositioning is required

You may need canthopexy if:

• You want mild tightening or support
• You are undergoing lower eyelid surgery
• You have early laxity, not shape issues
• You want prevention rather than transformation

Many patients do not need either, despite requesting them.

Can They Be Combined?

Yes—but carefully.

• Canthopexy is often combined with lower eyelid surgery
• Canthoplasty may be combined with other eye shape procedures
• Combination is only recommended when anatomy clearly supports it

Korean surgeons generally avoid stacking aggressive procedures unless absolutely necessary.

Recovery Differences

Canthoplasty

• More swelling at the outer corner
• Longer healing time
• Final shape settles over months

Canthopexy

• Minimal swelling
• Faster recovery
• Usually no obvious external change

Common Patient Misconceptions

❌ “Canthopexy will make my eyes bigger”
→ It won’t. It supports, not enlarges.

❌ “Canthoplasty is always better”
→ Not true. It carries more risk if unnecessary.

❌ “Everyone needs eye corner surgery”
→ Most people don’t.

Final Thoughts

The difference between canthoplasty and canthopexy is not subtle—it’s fundamental.

• Canthoplasty = shape-changing, structural surgery
• Canthopexy = supportive, stabilizing procedure

In Korea, the trend is strongly toward doing less, not more, and choosing the least invasive option that achieves a natural result.

A proper diagnosis of eye corner anatomy—not preference or trend—should determine which procedure, if any, is appropriate.