Cosmetic lateral canthoplasty and its potential complications

Lateral canthoplasty is a common cosmetic procedure whereby the outer corner of the eye is split to widen the horizontal aperture of the eye. It can be performed together with double eyelid surgery and medial epicanthoplasty to achieve longer and wider eye that makes the eye appear larger, wider and more attractive.


However, if not properly performed can give rise to complications. One of the complications that may arise from lateral canthoplasty is lacrimal ductule fistula, as seen in this patient. She had the lateral canthoplasty surgery done elsewhere a couple of months ago. She was referred to me for uncontrollable tearing. She started tearing a few weeks after the surgery. It has become a nuisance as she needs to wipe her eyes frequently and her eyeliner would not stay and smudge. 


The treatment for the fistula is called fistulectomy surgery whereby the tiny passage connecting to the lacrimal gland is excised and sutured.  

This patient underwent fistulectomy surgery and the tearing subsided immediately after the surgery.

Google Translate:

眼尾手术是一种常见的化妆品程序，使眼睛的外角被分割加宽眼睛的横向孔。它可与双眼皮和内眼角手术实现更长更宽的眼睛，使眼睛显得更大，更广泛，更具吸引力的进行。 

然而，如果没有正确地进行可产生并发症。一个可能产生的横向canthoplasty的并发症是下泪小管瘘，如在本例看出。她有横向内眼角手术别处做了几个月前。她称我为无法控制的撕裂。她开始在手术后撕裂了几个星期。它已成为一个麻烦，因为她需要经常擦拭她的眼睛和她的眼线不会留下污迹。 

为瘘的治疗被称为瘘管切除手术从而微小通道连接到泪腺切除和缝合。

这名患者接受了瘘管切除手术，手术后立即消退撕裂。

Doctor Help! I can't close my eye! 医生帮帮我！我不能闭上我的眼睛！

Lagophthalmos is a condition whereby one is unable to close the eyelid completely. It can be seen in a variety of conditions involving the facial nerve or eyelid itself. The common causes involving facial nerve is trauma, stroke or tumor. However, more commonly lagophthalmos is due trauma to the eyelids which form cicatrix, or after eyelid surgery whereby excessive eyelid skin has been removed. Lagophthalmos can also be seen in certain patients with prominent eyes such as Thyroid Eye Disease or high myopia. This condition may appear inconsequential but can be detrimental in the long run. Constant eye exposure to the air may dry the eye which leads to dryness, discomfort, foreign body sensation and reflex tearing.

Before and 4 days after scar subcision and hyaluronic acid gel filler

 The patient above sustained a full thickness eyelid laceration 2 years ago. She developed a notched eyelid margin and a contraction band that pulled the eyelid upwards causing lagophthalmos. She has been having tremendous discomfort and unable to sleep at night due to chronic exposure.

The definitive treatment for such condition is a reconstructive surgery. The eyelid margin needs to be reconstructed to yield a smooth alignment. The contraction band can be released by means of a Z-plasty. However, she has limited time in Malaysia and wanted a minimally invasive approach.

The contracted scar band was subcised and stented with hyaluronic acid gel filler. A few days later, I injected 5FU into the subcised scar band. She felt much more comfortable now and she told me she managed to sleep through the night, which she couldn't do in a long time.

This is not the definitive treatment but may help her to buy time while she arranges for the next visit to Malaysia for reconstructive surgery.

Combined Double Eyelid and Epi Surgery is more superior than Double Eyelid Surgery alone 联合双眼皮和眼角手术是比单纯做双眼皮手术更出众

In Asians or Orientals, there is a skin fold that covers the inner corner of the eye which makes the eye look small and narrow. This fold of skin is called the epicanthal fold. Inner corner eye surgery or medial epicathoplasty or in short, epi surgery is a surgery to correct the epicanthal fold and widen the width of the eye so that the eyes become larger and brighter. 

The conventional double eyelid surgery may increase the vertical height of the eye but does not address the epicanthal fold. Correcting the epicanthal fold will increase the horizontal width of the eye thus making the eye even larger and more attractive. In addition, it is easier to apply eyeliner and shimmery eye shadow when applied can be seen which brightens the eye further. 

Google Translate:

在亚洲人或东方人，有一个皮肤褶皱，覆盖这使得眼睛看起来小而窄眼睛的内角。皮肤褶皱这种被称为内眦倍。内眼角眼部手术或内侧epicathoplasty或短，外延手术是一种外科手术，以矫正内眦倍和扩大眼睛的宽度，使眼睛变得更大，更明亮。

传统双眼皮手术可能会增加眼睛的垂直高度，但并没有解决内眦倍。校正内眦折将增加的眼从而使眼睛变得更大，更吸引人的水平宽度。此外，它是比较容易申请眼线和当施加可以看出其照亮眼睛还闪闪眼影。

Asians vs Caucasians 亚洲人与白种人

Most people say Asian girls want to have eyelid surgery so they can look like caucasians. This concept of westernization is obsolete. Various eyelid surgeries (e.g double eyelid, epicanthoplasty or lateral canthoplasty) are aimed to create a visible eyelid crease, increase vertical or horizontal eye aperture so that the eyes appear to be larger and brighter, without losing one's ethnicity. In order to achieve that, it's important to study the face carefully and design an eyelid that best suits each individual so that it's harmoniously blended to the rest of the face. ~AG~

Google Translate: 

人们总是说亚洲/东方女孩想拥有双眼皮手术，使他们能够像白种人。西方的这种观念已经过时了。不同的眼皮手术（如双眼皮，内眼角或眼尾手术），旨在创建一个可见的双眼皮，增大垂直或水平眼光圈，使眼睛显得更大，更亮，又不失自己的种族。为了实现这一目标，重要的是要仔细研究的脸，设计出最适合每一个人，这样它和谐地融合到脸部其他处之。