Canthopexy as a routine blepharoplasty component.

Canthopexy should be a routine companion or alternative to lower lid blepharoplasty. It restores tone and youthful contour to the deteriorating eye, and it reduces or eliminates the need to resect skin that in truth is not excessive, but appears so owing to dropped lid posture from lid atonicity. Canthopexy with fat reduction and enhancement of the deficient suborbital portion of the malar complex should be the principal thrust of lower lid surgery. Skin removal accompanies this only when there is true excess and redundancy. Transconjunctival or stab wound fat removal are preferred procedures when there is no excess skin to remove. Canthopexies are possible through lower lid incisions, through upper lid incisions, or via coronal type access. They are an essential companion to aesthetic blepharoplasty if the surgeon wishes to prevent deformity.