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The Differences and Effects of Epicanthoplasty, Lateral Canthoplasty, and Lower Canthoplasty

Medical illustration comparing epicanthoplasty, lateral canthoplasty, and lower canthoplasty, showing how inner, outer, and lower eye corner procedures affect eye shape and width.

Table of Contents

About Canthoplasty

Canthoplasty is not simply a procedure to “make the eyes bigger.” It is a structural eye-design procedure that refines exposure, proportion, direction, and balance of the eyes.

Epicanthoplasty, Lateral Canthoplasty, and Lower Canthoplasty each target different anatomical areas, and suitability depends on individual eye structure and facial proportions.

Epicanthoplasty

Medical illustration explaining epicanthoplasty, a procedure that modifies the inner corner of the eye to reduce epicanthal folds and create a clearer medial canthal contour

Epicanthoplasty removes or releases the epicanthal (Mongolian) fold at the inner corners of the eyes, creating a refreshed and less constricted appearance.

Effects

  • Reveals hidden inner corners for a clearer look
  • Improves inner eye openness and crease definition
  • Enhances harmony with Semi-Out and Out-line designs

When Is It Recommended?

  • When a prominent epicanthal fold makes the eyes appear narrow or closed
  • When the eyelid crease is buried at the inner corner
  • When limited inner iris exposure makes the eyes look short or round

Important Considerations

  • Over-release may cause an unnaturally elongated inner eye shape; controlled release is essential
  • Scar visibility depends on technique and surgeon expertise (Z-plasty, M-plasty, etc.)

Lateral Canthoplasty

Diagram showing lateral canthoplasty, an outer eye corner procedure designed to extend the horizontal eye length and adjust eye shape by repositioning the lateral canthus

Lateral Canthoplasty extends the outer corners of the eyes, increasing horizontal eye width and creating a larger, more open appearance.

Effects

  • Expands horizontal eye length
  • Softens sharp or excessively upturned outer corners
  • Improves overall eye balance when lateral constriction is present

When Is It Recommended?

  • When the eyes appear short or narrow horizontally
  • When upturned outer corners create a harsh or cold impression
  • When additional horizontal widening is needed

Important Considerations

  • The outer canthus is prone to re-adhesion; secure fixation and appropriate release depth are critical
  • Excessive downward repositioning may cause scleral show and requires careful assessment

Lower Canthoplasty

lower canthoplasty lower eyelid eye surgery

Lower Canthoplasty lowers the outer corner below pupil level, increasing vertical exposure and creating a softer, more gentle impression.

Effects

  • Increases lower iris visibility
  • Produces a rounder, softer eye appearance
  • Reduces a harsh or overly lifted look

When Is It Recommended?

  • When upward-tilted outer corners create a stern appearance
  • When vertical eye openness is insufficient
  • When the eye shape lacks softness or curvature

Important Considerations

  • Over-lowering can cause excessive scleral show
  • Precise evaluation of lower eyelid length and support is essential

Which Canthoplasty Is Right for You?

Below are typical selection guidelines by eye structure. In many cases, one procedure alone is not enough, so combination planning matters.

Eye Structure / Concern Recommended Procedure Rationale
Prominent epicanthal fold
Epicanthoplasty
Improves inner exposure and crease clarity
Short, narrow eyes
Epicanthoplasty + Lateral Canthoplasty
Expands overall horizontal length
Upturned outer corners
Lateral Canthoplasty (downward adjustment)
Softens sharp impressions
Insufficient vertical openness
Lower Canthoplasty
Enhances lower iris exposure
Tight eye shape, buried crease
Epicanthoplasty + Ptosis Correction
Improves exposure and opening power
SEA / Thai-type thick skin & fat
Epicanthoplasty + Lateral + Incisional Method
Relieves tightness and improves durability

Myths vs. Facts About Canthoplasty

✓ Myth: More opening always makes the eyes bigger.

Fact: Canthoplasty changes exposure direction, not size.

✓ Myth: Epicanthoplasty always looks unnatural.

Fact: Controlled release techniques allow subtle, natural results.

✓ Myth: Lateral canthoplasty always re-attaches.

Fact: Re-adhesion is technique-dependent and can be minimized with proper fixation.

✓ Myth: Lower canthoplasty inevitably causes scleral show.

Fact: Only overcorrection causes this; proper planning preserves balance.

FAQ

Will combining epicanthoplasty and lateral canthoplasty look excessive?

It depends on eye structure. For Southeast Asian or Thai patients with constricted inner and outer corners, the combination often appears the most natural.

Yes. Epicanthoplasty in particular improves crease clarity and works well with Semi-Out and Out-line designs.

The most common reasons are insufficient fixation and limited release depth. Modern techniques reinforce fixation points to improve longevity.
Yes. Ptosis correction alone can significantly enhance eye clarity by increasing iris exposure.
Typically, horizontal length is addressed first with epicanthoplasty and/or lateral canthoplasty, followed by lower canthoplasty if additional vertical exposure is needed.

Travel & Recovery Schedule for Overseas Patients

Overseas patients are generally advised to stay at least 7 days in Korea.

This allows

  • Swelling to subside
  • Stitches removal (Day 5–7)
  • Initial recovery assessment

Minimum Stay

7 days is ideal for complete early recovery.

  • Surgery
  • 48-hour cold compression
  • Post-op check
  • Stitch removal
  • Initial swelling reduction

Leaving earlier than this is not recommended.

Pre-Surgery Precautions

  • Stop contact lens use
  • No alcohol or smoking 48 hours prior
  • Stop blood-thinning supplements
  • No heavy eye makeup
  • Remove eyelash extensions before surgery

Post-Surgery Care

0–48 Hours

 

  • Cold compress
  • Sleep with head elevated
  • No rubbing
  • No water contact


Day 2–7

 

  • Light cleansing allowed
  • Avoid soaking eyes
  • No makeup until stitch removal
  • Natural reduction of swelling & bruising

Stitch Removal

  • Mild swelling/bruising is normal
  • Temporary swelling may increase during flight
  • Warm compress before flight
  • Hydration is essential

Return Flight Timing

Most patients return home after Day 7.

  • Mild swelling and bruising are normal.
  • Temporary swelling may increase during flight.
  • Warm compress before flight.
  • Hydration is essential.
 

By 2–4 weeks, the appearance typically looks natural in daily life.

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