Things To Know About Epicanthoplasty And Lateral Canthoplasty

Canthoplasty is a form of eyelid cosmetic surgery that reshapes the corners of the eye where the upper and lower eyelids meet. It is a commonly used procedure to reshape and enlarge the eyes in people of East Asian descent.

What are Epicanthoplasty and Lateral canthoplasty?

Small eyes are highly unpopular in most Asian cultures, carrying the unfortunate connotations of looking either sly or unintelligent and inexpressive.  Before we dive into the details of what causes this appearance of small eyes and how this is corrected, below are a couple of terms you should be aware of:

– The canthus: this refers to either corner of the eye where the upper and lower eyelids meet. The inner corner of the eye (the part that is closer to the nose) is known as the medial canthus while the outer corner is referred to as the lateral canthus.

– The epicanthic fold: this is a fold in the skin of the upper eyelid that covers the inner corner of the eye and is a genetically inherited trait that is common in people of East Asian descent.

If your canthus (outer or inner corner of the eye) is covered by skin, your eyes look smaller and ‘stuffy’. Epicanthoplasty and Lateral canthoplasty are eye surgeries that help your eyes look larger and brighter, making your overall appearance much softer and clearer. These surgeries were initially performed in the West to repair eyelid dysfunction but were recast by Korean plastic surgeons as cosmetic surgeries to make the eyes appear more attractive. Distinct from the double eyelid surgery which alters the vertical dimensions of the eyes, epicanthoplasty and Lateral canthoplasty affects the horizontal dimensions by altering the inner and outer corner of the eyes.

Epicanthoplasty is performed to eliminate the epicanthal fold, or so-called the “Mongolian fold” and enlarge the opening of the inner corner of the eye. Epicanthal fold is a portion of eyelid skin obstructing the inner corner of the eye and, thereby, impairing the beauty of the eye by making it look sleepy, horizontally short, and widely spaced. By opening the inner corner of the eye, the surgery decreases the intercanthal distance, making the eyes appear to be closer together, closer to the ideal ratio beween the eyes and intercanthal distance of 1:1. It also reveals the medial half of the eyes making the eyes appear bigger, softer and more natural and expressive.


Lateral Canthoplasty reshapes the lateral epicanthus by excising the skin covering the lateral canthus. This surgical procedure increases the exposure of the white eye, making the eye appear longer and opened. Those with upward sloped outer eye corners also seek this surgery since the inferior eyelid can be pulled by the physician to a position parallel to the medial canthus, to ultimately create semi-circular, big round doll eyes that the patients desire. Traditionally, this surgery often resulted in eventual re-attachment of the dissected skin, but ongoing advancements in surgical methods have allowed for a permanent result.


Usually, these surgeries are performed in conjunction with the double eyelid surgery and are sought by those who wish to attain a more westernized look, and thus it is very popular among celebrities in Asian countries, especially those in Korea, who wish to have bigger and brighter eyes that look attractive on screen.

How is Epicanthoplasty performed?

Before the surgery, the severity of the epicanthal fold is assessed during the pre-surgical evaluation process. The physician then calculates how wide your inner eyelids will be cut and marks the incisions with a pen. Local anesthesia is injected around the eyes to eliminate pain. During the surgery, you are awake to communicate with the surgeon. The surgeon uses the pre-planning marks to restructure the shape of the inner eyelid by creating small flaps through the incisions. Excess skin and fat are removed during the process. After the epicanthal fold is successfully altered, the physician closes the open skin folds by carefully suturing the area.

The operation takes less than 30 minutes. No hospitalization is required since it is a relatively simple surgery. However, at least 1 or 2 hours are needed to cool the eyes down before the patient is allowed to leave the clinic. Stitches are removed after 5-7 days, depending on the thickness of the skin and speed of recovery. Since eyelids would appear unusually swollen after the surgery, a recovery period of two weeks is recommended for the patients. Pain medication is prescribed to control pain after surgery, and eye makeup is not recommended until the stitches are removed.


What are the possible side effects of Epicanthoplasty?

Epicanthoplasty is a surgery with a high success rate. However, there are a few complications that should be understood by the patients. First, visible scars could remain in the surgical site. These scars may be noticeable for a few months after the surgery. Furthermore, incisions could become infected during the surgery. However, this is a rare complication that hardly occurs. Overall, the surgery is safe and results in little side effects, leading to high satisfaction in the patients.

How is Lateral Canthoplasty performed?

Lateral Canthoplasty is performed with the same procedures as Epicanthoplasty, except that incisions are made on the outer corner of the eyes. Once the physician opens up and successfully restructures the site, the area is carefully sutured.

Similar to Epicanthoplasty, no hospitalization is required. The surgery is performed in 45 minutes. Recovery is possible in a short period of time of 7-10 days. Stitches are removed 7 days after the surgery. After the surgery, smoking and alcohol should be avoided for at least a month. Contact lenses should be avoided until the surgical site is healed.


What are the possible side effects of Lateral Canthoplasty?

The scar is less visible compared with the scar left by Epicanthoplasty since the surgical incision is hidden at the margin of the superior and inferior eyelash skin margins. However, since the dissected section of the eyes does not have eyelashes growing, temporary redness or other allergic symptoms may be present. Furthermore, Lateral Canthoplasty usually ends in less satisfaction among the patients compared to Epicanthoplasty, since it produces a less visible change in the appearance of the eye.

Warning: Patients under these conditions may be unable to undergo Lateral canthoplasty:

–   Patients with a higher proportion of sclera (white part of the eye) on the lateral side than on the medial side.

–   Patients with chronic eye disease or eyes unable to tolerate stimulus to the cornea

–   Patients with saggy undereye skin at the lateral canthus

–   Patients who do not wish to have eyelash inversion at the dissection site


There is a saying that the eye is the window to the soul. Eyes are in fact the most important feature in determining your facial appearance. If you are just unsatisfied with your small, upward slanted eyes that make you appear fierce and unfriendly, you may consider Lateral Canthoplasty and Epicanthoplasty as a way to enhance you’re appearance and boost your self confidence.

If you are considering double eyelid surgery, having a Canthoplasty surgery in conjunction would definitely help you get those friendly looking, brighter eyes you always longed for without having to go under knife multiple times.

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