Cosmetic lateral canthoplasty

Background: Although there are patients who want cosmetic lateral canthoplasty to lengthen the lateral palpebral fissure of the lateral canthal area, no recommendable operational procedure exists that results in an accepatable scar formation. Because of the round eyeball shape, lengthening and widening of the lateral palpebral fissure should not be in the lateral direction, but rather in the posterior direction to keep the surface between the bulbar conjunctiva and the palpebral conjunctiva in contact. Methods: The authors believed that using an upper crus flap of the upper eyelid margin as a transposition flap would enable lengthening of the lower eyelid width and posterior deepening of the lateral canthal area. This was thought possible by transverse back-cutting of the palpebral conjunctiva on the lateral fornix area. Results: The authors have performed cosmetic lateral canthoplasty in more than 200 cases to increase the width of the lateral palpebral fissure. All the results were satisfactory and aesthetically acceptable. Conclusions: The reported surgery makes the eyes appear larger and brighter. The authors think this procedure is a good and convenient method although it is not perfect.