Complications Following Lateral Canthoplasty

“Outer canthoplasty” (also known as “lateral canthoplasty”) refers to a surgical procedure that involves opening the lateral canthus—the junction point of the upper and lower eyelids at the outer corner of the eye. By releasing this area and gently repositioning the inner conjunctiva outward, the overall appearance of the eye is elongated. Since eyelashes naturally grow in this region, even though the incision involves the inner conjunctival surface, occupying space here creates an effect of eye enlargement. However, because no eyelashes grow in the newly exposed area, the overlying skin may appear slightly reddened. So, what are the potential complications of outer canthoplasty? Below, we address this question.

Complications of Outer Canthoplasty

1. Risk of Visible Scarring

Some patients develop noticeable scars following outer canthoplasty. This is often related to the direction and angle of the surgeon’s incision: the greater the inclination angle, the deeper the injury to the dermis—and consequently, the more prominent the resulting scar. Additionally, suboptimal suture technique or use of low-quality suture materials may further exacerbate scar visibility. To minimize this potentially serious complication, patients should seek treatment exclusively at accredited plastic surgery centers and choose experienced, highly skilled, and conscientious surgeons.

2. Prolonged Scar Maturation Period

Some patients notice that scar healing after outer canthoplasty takes longer than expected. This reflects inherent physiological characteristics of wound healing: typically, scars soften and gradually regain normal pigmentation over a period of 3–6 months. Such delayed maturation is a universally encountered postoperative phenomenon among all surgeons performing outer canthoplasty. Strategic placement and camouflage of the incision—such as aligning it with natural skin folds or creases—can significantly reduce the visual impact of scarring on overall eye aesthetics.

3. Unnatural or Distorted Appearance

If the surgeon fails to integrate fundamental aesthetic principles—such as the “Three-Thirds and Five-Eyes” facial proportion guidelines—with the patient’s unique facial anatomy during preoperative planning, outer canthoplasty may result in an unnatural or distorted appearance. Similarly, unrealistic expectations—for instance, demanding an exaggeratedly wide-eyed look—may also lead to unsatisfactory aesthetic outcomes. Only through close collaboration between patient and surgeon to establish a realistic, mutually agreed-upon surgical plan—and subsequent precise execution by a qualified professional—can such complications be effectively avoided.

4. Epiphora (Excessive Tearing)

Some patients experience persistent tearing following outer canthoplasty—a sign that may indicate laceration or disruption of the lacrimal canaliculi. The medial canthal region contains delicate anatomical structures; inexperienced or unqualified practitioners (“quack doctors”) unfamiliar with these fine ocular landmarks risk inadvertently damaging critical tissues—including the lacrimal drainage system—during surgery. To prevent this complication, patients must undergo outer canthoplasty only at reputable medical institutions under the care of certified specialists.

5. Infection

Patients should also be aware that infection remains a possible complication of outer canthoplasty. This may occur due to inadequate intraoperative sterilization or improper postoperative wound care. Should any abnormal symptoms—such as increased redness, swelling, pain, or discharge—arise during recovery, prompt medical evaluation is essential.

The above outlines common complications associated with outer canthoplasty. We hope this information proves helpful to you.