How Can I Change My Lower Eyelid Shape and Have Less Scleral Show?

Q: Dr. Eppley, I’m quite unhappy with my lower eyelid shape and sclera show. Naturally I did some research and checked my options including canthoplasty which brought me to your homepage (very informative). with interest I read the following article of yours: 

Case Study – Lateral Canthopexies for Changing The Corner Of The Eye

The following questions occurred to me: 

1. do you offer this surgery and do you also treat foreigners? 

2. how long lasting will the result be? i heard that canthopexy is opposite to canthoplasty and isn’t really permanent? 

3. can you specify what do you mean with ” A lateral canthopexy technique is less likely to round out the eye shape and shorten the horizontal length of the lower eyelid.”? Does that mean the whole eye will get shortened horizontal and the palpebral fissure length will decrease when i would choose a canthoplasty? 

4. is there a way to actually increase the palpebral fissure length? if yes, do you offer such surgery? 

Best regards

A: Thank you for your inquiry regarding lower eyelid reshaping surgery. In answer to your questions:

1) I do not write about procedures I do not do. About 15% of my prepandemic practice was from outside the US.

2) Canthopexy can be permanent based on how it is performed and secured to the lateral orbital rim.

3) By definition either a lateral canthopexy or canthoplasty derounds the lower eyelid through altering the position of the junction of the upper and lower eyelids at the outer corner of the eye to a higher position. This does not constitute increasing lower lid length.

4) There is no effective procedure for increasing the palpebral fissure length as you can’t pull the lid corner away from close contact to the eyeball. That tight relationship is of critical functional importance.

Dr. Barry Eppley

Indianapolis, Indiana