Doctor, Can you make my eyelids longer?

In order to make the eyelid bigger, there are 2 factors to look at :

1. Vertical aperture

2. Horizontal aperture.

The horizontal aperture can be increased by lengthening the inner eyelid corner or outer eyelid corner. This blog will discuss about how to increase the horizontal aperture of the eyelid by increasing the length of the outer eyelid. You may read about the inner eyelid corner lengthening through Magic Epicanthoplasty via link below.

Magic Epicanthoplasty

The outer corner fo the eye where the upper and lower eyelid joins is called the lateral canthus (figure 1). The tendon that holds the lateral canthus to the bone is called the lateral canthal tendon (figure 2). 

The vertical and horizontal aperture is shown here. The inner corner of the eye
is medial canthus and the outer corner of the eye is called lateral canthus.

Figure 2. The lateral canthus is supported by lateral canthal tendon 
attached to the bone.

Over time, the lateral canthal tendon become weak and sags as seen in older patients which may give rise to eyelid malposition. To correct this, the lateral canthal tendon is tightened through surgery to support the aging eyelids.

To widen the eyelids for cosmetic purpose, the lateral canthus can be modified surgically. Cosmetic lateral canthotomy is a simple procedure whereby the lateral canthus is split to widen the horizontal aperture of the eyelid. In this procedure, it is imperative that the lateral canthal tendon is not disrupted so as to maintain the anatomic relationship of the lateral canthus to the bony structure. Therefore, an additional of only 2-4 mm can be achieved with this procedure.  This can be performed along with double eyelid procedure (whether suture or incision technique) and magic epicanthoplasty to achieve longer and wider eye that makes the eye appear larger, wider and more attractive. 

The lateral canthus is split to increase approximately
2-4 mm of the horizontal width of the eyelid.

This patient underwent double eyelid procedure with 

suture method together with lateral canthotomy 

which added an additional 3mm to her eyelid aperture.

As this is a delicate surgery, please make sure that you go to a qualified surgeon if you want to get this procedure done. The surgeon has to understand the anatomy of the eyelid and not compromise the inter-relationship of the lateral canthus and lateral canthal tendon.

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。