When a canthoplasty intended to create large, refreshing eyes leaves severe side effects on both ends of the eyes, the psychological distress is beyond imagination. Especially if there is a deep depressive scar resembling a fingernail mark at the inner corner, and the outer corner is bluntly spread into a U-shape (webbed deformity) exposing the red mucosa, making eye contact with others can become a fear.
If both the inner and outer structures are ruined, it is natural to want to correct both in a single surgery. However, in many cases, clinics recommend separating the surgeries due to tissue tension and recovery burden. Today, we will deeply explore a clinical case where She One Plastic Surgery safely performed a simultaneous canthoplasty revisionbased on a profound understanding of anatomical structures to restore the balance of ruined eyes.
complication following medial and lateral canthopalsty : depressive scar and webbed deformity
1. The Core of Revision: Limits of Skin Tension and Simultaneous Correction
In plastic surgery, revision involves delicately dissecting scar tissue and gathering scattered ligaments for suturing. This inevitably generates ‘tension’ where the skin is pulled tightly. If both the front and back of the eye are closed simultaneously, this tension concentrates excessively, risking the wound re-opening or the eyes becoming unnaturally small.
However, She One Plastic Surgery thoroughly calculates the patient’s remaining skin capacity and tissue elasticity through advanced clinical precision. We avoid the method of forcibly pulling and suturing only the outer skin. Instead, we firmly reposition the internal ligaments and muscles—the framework of the eyes—step by step from the deep layers. By effectively distributing the tension applied to the skin surface, we can smoothly achieve simultaneous inner and outer revision without straining the tissues.
2. Reconstructing the Internal Structure of Fingernail-like Inner Corner Scars
A deeply depressed scar at the epicanthoplasty site is not just a surface wound. It is the result of ‘adhesion,’ where the skin severely caves inward and tangles as the remaining tissues heal after excessive excision of skin and micro-muscles during the first surgery.
Therefore, merely applying laser treatments or ointments cannot fill the depressed space. A double flap technique and internal structure reconstruction, which carefully release the tightly adhered scar bands and seamlessly reconnect the severed micro-muscle layers, must accompany the procedure to restore the depressed scar to a flat and smooth state.
3. Webbed Outer Corners: The Importance of Re-anchoring the Lateral Canthal Tendon
If the outer corner spreads bluntly into a U-shape and exposes red flesh after lateral canthoplasty, it is a clear signal that the ‘lateral canthal tendon,’ which maintains the eyelid’s shape, has detached from the bone and lost its supportive strength.
In this state, simply tying the spread outer skin with threads as a temporary fix will not withstand the physical force of blinking, causing the scar to reopen over time. For fundamental shape restoration, it is essential to locate the dysfunctional lateral canthal tendon and firmly re-anchor it to its original position inside the orbital bone, while precisely realigning and suturing the damaged gray line (the border of the upper and lower eyelids).
4. Positive Changes in Stabilized Eyes After Simultaneous Revision
Simultaneous Canthoplasty Revision Before and After
This is the progress at a point where the scar tissue has softened and the tissues have gradually entered a stabilization phase after completing the complex revision surgeries.
Looking at the results, you can see that the depressive scar casting a shadow like a deep fingernail mark at the inner corner has been smoothly refined through internal structure reconstruction. At the same time, the outer corner that was excessively spread and exposing the red mucosa has been softly closed into its natural, sharp V-shape through lateral canthal tendon fixation, restoring the overall harmonious balance of the eyes.
A Reliable Supporter Easing the Heavy Burden of Your Long Surgical Journey
She One Plastic Surgery deeply sympathizes with the heavy hearts of patients whose daily lives of facing others have shrunken due to failed surgical outcomes and distinct scars.
Our clinic rejects cookie-cutter surgeries. We precisely analyze the patient’s skin thickness and scar depth on a 1:1 basis to propose only the safest and most suitable surgical plan that the tissues can handle. For patients exhausted from multiple failures and revision surgeries, we will help you return to a comfortable daily life by correcting the collapsed structure of your eyes. We will dedicate our utmost care to every consultation as your reliable companion on your long journey of recovery.
* Before and after photos of this patient are available on the She One Plastic Surgery official blog. *
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The before and after photos featured in this post are shared with the patient’s explicit consent, strictly complying with Article 23 of the Medical Service Act. Please note that individual recovery times and surgical results may vary, and potential side effects can occur. We strongly advise a comprehensive consultation with our medical team before making any surgical decisions.
