• Archives of Plastic Surgery
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• v.43 no.4
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• pp.321-327
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• 2016

There are many women who want larger and brighter eyes that will give a favorable impression. Surgical methods that make the eye larger and brighter include double eyelidplasty, epicanthoplasty, as well as lateral canthoplasty. Double eyelidplasty produces changes in the vertical dimension of the eyes, whereas epicanthoplasty and lateral canthoplasty create changes in the horizontal dimension of the eyes. Epicanthoplasty, a surgical procedure which enlarges the eye horizontally, is performed at the inner corner of the eye, whereas lateral canthoplasty enlarges the outer edge of the eye. In particular, if the slant of the palpebral fissure is raised and the horizontal dimension of the palpebral fissure is short, adjusting the slant of the palpebral fissure through lateral canthoplasty can achieve an enlargement of eye width and smoother features. Depending on the patient's condition, even better results can be achieved if this procedure is performed in conjunction with other procedures, such as double eyelid-plasty, epicanthoplasty, eye roll formation surgery, fat graft, and facial bone contouring surgery. In this paper, the authors will introduce in detail their surgical method for a cosmetic lateral canthoplasty that lengthens the lateral canthal angle and corrects the outer tail of the eyes, in order to ease the unfavorable impression.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.641-646
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• 2007

Purpose: Lateral canthoplasty is utilized in aesthetic surgery to lengthen the lateral palpebral fissure of the lateral canthal area. However, complication such as recurrence, contour deformity or hypertrophic scar make its results doubtful. Therefore, we developed lateral canthoplasty with lateral canthotomy and Y-V advancement to effectively lengthen the palpebral fissure without recurrence. Methods: A total number of 117 patients were reviewed from March 1991 to April 2005. The operative procedure was lateral canthoplasty with lateral canthotomy and Y-V advancement. To prevent recurrence, we dissected lateral conjunctiva of lower eyelid. The author believes that by this procedure, V flap would be able to advance laterally without tension. Results: We performed lateral canthoplasty in 117 patients. There were no recurrence and patients were satisfied with the results. There were 12 patients who presented with complication. Complication included hypertrophic scar in 4 patients, web formation in 3 patients and over-correction in 5 patients. Conclusion: Lateral canthoplasty with lateral canthotomy and simple Y-V advancement may be used as an effective method to lengthen palpebral fissure without recurrence.

• Archives of Plastic Surgery
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• v.43 no.4
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• pp.316-320
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• 2016

Cosmetic lateral canthoplasty, in which the size of the eye is increased by extending the palpebral fissure and decreasing the degree of the eye slant, has become a prevalent procedure for East Asians. However, it is not uncommon for there to be complications or unfavorable results after the surgery. With this in mind, the authors have designed a surgical method to reduce complications in cosmetic lateral canthoplasty by preserving the lateral canthal angle. We discuss here the anatomy required for surgery, the surgical methods, and methods for reducing complications during cosmetic lateral canthoplasty.

• Archives of Plastic Surgery
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• v.43 no.4
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• pp.311-315
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• 2016

In Korea, lateral canthoplasty, along with medial epicanthoplasty, has become popular over the past years to widen the horizontal length of the palpebral fissure. However, the effect of the surgery differs greatly depending on the shape and structure of the eyes. If over-widened, complications such as eversion, scarring, and conjunctival exposure may occur. Thus, the author of this study suggests a more effective and safe method for lateral canthal lengthening that causes minimal complications. A total of 236 patients underwent lateral canthoplasty between July 2007 and December 2015. For each patient, a triangular flap 4-5 mm away from the lateral canthus was elevated and rotated 45 degrees laterally while the continuity of the lower eyelid gray line was maintained. A new lateral canthus was created by fixating the rotation flap to the lateral orbital rim with minimal skin trimming and tension-free sutures, preventing relapse and maintaining a triangular shape. In more than 95% of cases, effective and satisfactory extension was achieved. On average, a 3 mm extension of the lateral canthus was achieved. There were minor complications such as wound dehiscence, webbing, and scarring, which were easily corrected. The author not only extended the lateral canthus 3-4 mm laterally but also maintained the continuity of the gray line on the lower lid as a more natural-looking triangular shape, while minimizing complications such as webbing and conjunctival exposure.

• Journal of Veterinary Clinics
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• v.34 no.2
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• pp.123-125
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• 2017

An eight-year-old Shih-Tzu dog was referred to Kyungpook National University Veterinary Medical Teaching Hospital because of severe glaucoma and exophthalmos. The symptoms included severe buphthalmos, conjunctival hyperemia, focal dried cornea and discomfort in the affected eye. Although enucleation was considered as a potential intervention measure in light of the severity of symptoms, it was possible to save the globe and relieve symptoms through evisceration, intraocular prosthesis implantation, and lateral canthoplasty. Our experience with this case suggests that symptomatic salvage therapy, rather than enucleation, is an appropriate approach for resolution of exopthalmos and other complications associated with glaucoma surgery.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.3-9
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• 2019

Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.9-14
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• 2020

Background Eyelids vary in morphology and structure depending on age, sex, and race. Usually, one-dimensional measurements are used to evaluate blepharoplasty outcomes. However, in recent years, three- or four- directional enlargements of the eyelid have been used for blepharoplasty in Asian patients, and the outcomes of techniques such as lateral canthoplasty or canthotomy and medial epicanthoplasty with increased scleral area cannot be analyzed using marginal reflex distance 1 or the area of corneal exposure. Therefore, we describe the use of a measurement method based on the eyeball exposure area (EEA). Methods To obtain normal EEA values by age and sex, 320 individuals were recruited. The participants were divided into eight age groups (n=40 in each group: female subjects, n=20; male subjects, n=20): 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-89 years. The EEA value was obtained by dividing the exposed area by the total eyeball area. The normal EEA values and differences in EEA according to age and sex were calculated. Results The mean EEA values for male and female subjects were 66.86% ±9.20% and 71.48%±10.48%, respectively. In each age group, the EEA values of females were higher than those of males. EEA decreased significantly with age in both male and female subjects (P<0.05). Conclusions We determined normal EEA values according to age and sex. EEA can be used as an indicator of the outcome of blepharoplasty.