Lower Eyelid Suspension Combined With Lateral Canthopexy

This method is the standard treatment for patients with mild and moderate palpebral ectropion or for those whose lower eyelid still has elasticity. The surgery mainly involves regional or overall resection via the original lower eyelid incision, which releases and detaches adhesive scars inferior to the eyelids, suspends the lower eyelid muscle and skin to the lateral eye corner, and fixates the loose skin with non-absorbable sutures to the ligament and periosteum lateral to the orbital bone. In this way, it elevates and tightens the overall lower eyelid skin and prevents the recurrence of eccrctropion. This surgery causes temporary or persistent eye shrinkage or eye shape change (ex. slanted eye), which needs approximately more than 3 months of recovery and observation to confirm surgical success.

Surgical conditions


  • Type of anesthesia: IV sedation + local anesthesia
  • Surgical incision: Close to the eyelash at the lower eyelid (original incision of the prior lower blepharoplasty)
  • Recovery: 7–10 days
  • Removal of stitches: 7 days

General instructions

No food and water on the day of surgery

  • Apply cosmetic gel to the lower eyelid for 2 weeks postoperatively to stabilize the surgical results.
  • Avoid smoking, alcohol, and irritating foods for 1 month postoperatively.
  • Avoid staying up late for 3 months postoperatively 3, and sustain eye warm compresses till the swelling completely subsides.

Ideal candidates

  • Patients with mild and moderate eyelid drooping or palpebral ectropion
  • Those whose palpebral elasticity cannot be recovered after the application of cosmetic tapes to the lower eyelid for over 3 months
  • Those with acute or chronic conjunctivitis due to palpebral ectropion
  • Those with imbalanced eyeball motion or diplopia due to palpebral ectropion
  • Those with excess inferior white eyeball exposure that affects the appearance

Potential complications

  • Scar hyperplasia and adhesion
  • Recurrent ectropion
  • Eye shape change
  • Eye size shrinkage

Surgical advantages

  1. The surgery is relatively simple, and the patient recovers rapidly.

  2. Surgical trauma is mild, which recovers rapidly.

  3. The success rate of the mild ectropion correction is high (80%)

  4. It can be combined with regional midface lift to improve laxity of the cheek laxitys.

Surgical drawbacks

  1. It may result in changes in eye shape or size.

  2. It is unable to improve the conditions of patients with severe palpebral ectropion or excess shortage of lower eyelid skin.

  3. A lLower eyelid scar may show recurrent adhesion and contraction that leads to recurrence (approximately 20%).

Before & After

These photographs represent typical results, but not everyone who undergoes plastic surgery will achieve the same.

Lower Eyelid Suspension Combined With Lateral Canthopexy