Almond Eye Surgery (Canthoplasty): Process, Recovery and Risks

Almond eye surgery ("cat eye" surgery; medically known as canthoplasty or canthopexy) is an operation that aims to give the eyes an almond-shaped appearance with a slightly upturned outer corner by reshaping the outer corner of the eye and the surrounding tissues. Because everyone's eye structure is different, other people's experiences do not predict a personal result; the decision should be made after an examination, once expectations and risks have been discussed.

What Change Does Almond Eye Surgery Make?

In the operation, the ligament that supports the outer corner of the eye (the lateral canthal tendon) is tightened or reattached at a higher point; in this way the outer corner of the eye sits slightly higher than the inner corner. When necessary, the outer part of the eyebrow or the temple area can also be lifted. The aim is to give a more balanced angle to an eye corner that slopes downwards or looks tired. The change that can be achieved depends on the person's bone structure, the position of the eyeball and the eyelid tissue; not every eye shape can be changed to the same degree.

Who Is It For?

Almond eye surgery may be considered in the following situations:

People whose outer eye corners slope downwards from birth
People whose outer eye corners and lower eyelids loosen with age
People whose general health is suitable for surgery and whose expectations are realistic

A detailed assessment is needed in people with dry eye, prominent eyes, thyroid eye disease or previous eyelid surgery. If the eyelid itself is drooping (ptosis), almond eye surgery does not correct this problem; for details you can read our article Drooping Eyelid (Ptosis): What Is It and How Is It Treated?.

Preparing for Surgery

At the examination, the eyelids, eye corners, eyebrows, temple area and the differences between the two eyes are assessed, and expectations are discussed.
All medicines used, especially blood thinners and herbal products, are reported to the doctor.
Because smoking can impair healing, stopping for the period recommended by the doctor is advised.
If general anaesthesia is planned, the fasting period before surgery is given by the doctor and the anaesthesia team.
No make-up or cream is applied around the eyes on the day of surgery.

How Is the Operation Performed?

The operation can be performed under local or general anaesthesia. Through a small incision at the outer corner of the eye, the ligament supporting the corner is reached; the ligament is tightened or fixed to the bony rim of the eye socket at the planned height. When necessary, excess skin or fat can be removed from the upper or lower eyelid, and procedures that lift the outer part of the eyebrow or the temple area can be added. The doctor decides which procedures will be performed, the type of anaesthesia and the duration of the operation. For information about procedures on the eyelids you can read our article Eyelid Surgery (Blepharoplasty): What Should You Expect?.

What Should Be Watched For After Surgery?

Swelling, bruising and a feeling of tightness at the eye corner are expected in the first days. In the early period the eye corner may look higher than planned; it settles as the swelling goes down.
Cold compresses are applied as the doctor recommends; in the first days the person sleeps on the back with the head raised.
The eyes are not rubbed and the stitches are not touched; the recommended drops and ointments are used regularly.
Smoking and blood-thinning medicines not recommended by the doctor are avoided.
The doctor decides when showering, make-up, contact lenses, exercise and returning to work are possible.

Risks and Limits

Like any surgical procedure, almond eye surgery has risks. Asymmetry between the two eye corners, the eye corner being raised more or less than expected, tightness, pulling down or turning outwards of the lower eyelid, being unable to close the eye fully and dry eye, a scar or change of shape at the eye corner, infection and bleeding may occur. The eye corner may partly return to its former position over time; in some cases a corrective operation may be needed. If increasing pain, rapidly increasing swelling around the eye or reduced vision occurs after surgery, a doctor should be seen without delay.

How Long Does the Result Last?

How long the result lasts depends on the person's tissue structure, the technique used and the ageing process; the operation does not stop ageing or the effect of gravity. For the difference from the non-surgical option you can read our article Almond Eye Surgery or Almond Eye Filler?, and for detailed information you can visit our almond eye surgery page.

Author: Op. Dr. Yücel Sarıaltın