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Canthoplasty is a oculoplastic procedure for changing the position or configuration of the canthus in order to correct deformities or to provide additional support to the lower eyelid. It is distinguished from canthopexy, a surgical procedure used to tighten lower eyelids, but during which tendons and muscles are not cut or detached.

History
The plastic surgery is a branch of medicine which started to grow rapidly since the beginning of the 20th century and, even if it was also performed many centuries ago, it became succesful only after the world wars, which increased the need for plastic surgery.

The first descriptions of this surgery, known with different names during time, date back to 1911, when Lexer and Eden described a procedure to suspend the lower eyelid, then it was thanks to surgeons like Tenzel, Whitaker, Anderson and Gordy that it became a relatively easy and unpainful surgery used for different needs. The operation has evolved to become adapted to the anatomy of the individual.

Uses
The surgery can be performed for cosmetic or medical reasons, with lower eyelid malposition (laxity, ectropion, entropion or retraction) and lateral canthal dystopia being among the most common reasons for canthoplasty. Ectropion is a condition in which the lower eyelid droops and forms a gap that can become irritated. Drooping eyelids can be due to the ageing process, which decreases the tonicity of the lower eyelid, especially of the lateral canthal tendon. Canthoplasty can be combined with blepharoplasty with the aim of facial rejuvenation, but some people in their 20s or 30s are also interested in this operation for the possibility to alter the shape of their eyes ( to achieve a "cat eye" shape).

Asian canthoplasty is a common procedure in the Asian community used to make the Asian eyes bigger in patients with narrow lids or a close lateral canthus.

Surgical procedures
Among the various surgical alternatives, the traditional method is the lateral tarsal strip, which can be summarized in the following steps: division of either canthus of the eye (canthotomy); division of inferior canthus (inferior cantholysis); removal of eventual excessive skin; splitting of part of the lateral lid; removal of the meibomian orifices; scraping of lateral conjunctiva; securing of the lateral strip of tarsus to the periosteum with two sutures; sutures to close the obicularis layer and skin.