After lateral canthoplasty surgery, when deformations such as lateral canthus widening or conjunctival exposure occur, it is often thought that both eyes must undergo revision surgery. However, if the deformation is prominent in only one eye or if left-right asymmetry in lateral canthus height is distinct, using the normal eye as a reference and precisely restoring only the deformed eye can be a more refined alternative approach. In this article, based on cases of unilateral deformation caused by lateral canthoplasty side effects, we examine the medical principles of grey line reconstruction and relief of lateral canthus asymmetry.
Why Only One Lateral Canthus Becomes Deformed as a Lateral Canthoplasty Side Effect
If the grey line at the lateral canthus is damaged during previous lateral canthoplasty surgery, conjunctival exposure and lateral canthus widening may be prominent on only one side.
Lateral canthoplasty is a surgical technique that precisely incises the external conjunctiva and membrane at the lateral canthus to expand the eye shape horizontally. If the grey line, which is the boundary line at the end of the lateral canthus, is damaged during this process, the conjunctiva droops downward causing scleral show or eversion deformity where the lateral canthus widens outward. Such deformations tend to appear more severely on one side rather than symmetrically on both sides due to differences in tissue response at the surgical site, and this can result in left-right lateral canthus height differences of approximately 3-5mm.
Why Restoring Only One Eye Can Align Left-Right Symmetry
When left-right lateral canthus height difference is approximately 3-5mm, an approach of restoring only the deformed side using the normal eye as reference can be an effective alternative.
When deformation occurs in only one eye or when the degree of lateral canthus inclination difference between left and right is distinct, a selective restoration method can be applied using the shape of the normal opposite eye as a baseline to restore only the deformed eye. In fact, in cases where left-right lateral canthus height difference is approximately 3-5mm, an approach of reconstructing only the deformed side without re-incising the opposite eye, which already maintains a stable form, is being considered as a method that minimizes tissue damage while enhancing the effect of asymmetry correction.
Preservation Restoration and Single-Side Restoration, What's the Difference?
If maintaining eye size is the priority, preservation restoration can be considered; if complete grey line reconstruction and asymmetry relief are the priority, single-side restoration can be considered.
Lateral canthoplasty revision surgery can be broadly divided into two approaches depending on the purpose. One is preservation restoration, which maintains the horizontal length of the eye enlarged by lateral canthoplasty as much as possible while refining only the deformed area, and the other is single-side restoration, which focuses on returning the grey line to its original position. Preservation restoration is considered if eye size reduction is to be minimized, but if stabilizing the widened conjunctiva and maximizing relief of left-right lateral canthus height and inclination asymmetry is the priority, single-side restoration focusing on grey line reconstruction may be a more suitable option. Since both approaches have different applicability depending on individual tissue condition and degree of deformation, precise diagnosis prior to surgery is necessary.
| Category | Preservation Restoration | Single-Side Restoration (Grey Line Reconstruction Type) |
|---|---|---|
| Main Purpose | Maintain eye size enlarged by lateral canthoplasty | Grey line reconstruction and asymmetry relief |
| Suitable Candidates | Cases where eye size reduction is not desired | Cases with severe conjunctival exposure and asymmetry where restoration to original condition is priority |
| Recovery Period (Approximate) | Approximately 7-10 days until suture removal | Approximately 7-10 days until suture removal, soft tissue stabilization approximately 2-3 months |
| Characteristics | Focus on minimizing changes in eye shape size | Focus on recovering the atmosphere of the eye shape before deformation |
Recovery Progress After Unilateral Restoration: Early and Mid-Stage Changes
Suture removal occurs approximately 7-10 days after surgery, and approximately 2-3 months later, tissue and scars stabilize.
After unilateral lateral canthoplasty revision surgery, suture removal generally occurs between 7-10 days, and during this period temporary bruising and minor swelling may occur. This is known to be a natural response in the tissue healing process, and gradually subsides as time passes.
Approximately 7-10 days until suture removal after unilateral restoration and approximately 2-3 months until tissue and scar stabilization are reported in the recovery course.
After approximately 2-3 months have passed, the tissue around the eye and scar lines become softer, and as the widened conjunctiva becomes closely adhered to the lower eyelid margin, relief of left-right lateral canthus height difference is also reported. However, recovery speed and final results may vary depending on individual tissue condition.
Particular Precautions in Unilateral Restoration Surgery
The fixed vector must be adjusted precisely based on the curve and angle of the opposite normal eye; otherwise, there is a risk of creating new asymmetry.
The approach of surgically treating only one eye to achieve left-right balance requires higher precision than simultaneous bilateral surgery. This is because the lateral canthus angle, curve, and degree of ocular protrusion of the non-operated opposite eye must be continuously cross-referenced while adjusting the suturing direction and tension in minute detail. Without such reference, simply closing the deformed area can actually create new asymmetry in the opposite direction, so it is recommended to undergo thorough consultation with medical professionals with 6 or more months of clinical experience in eye reconstruction and proceed with individualized customized design.
Clinical Approach for Improving Eye Shape Asymmetry
Eye reconstruction care can be approached through 1:1 pre-surgery consultation to precisely analyze lateral canthus inclination and tissue condition.
Eye shape deformation caused by lateral canthoplasty side effects often leads to psychological burden. Particularly when left-right shapes have changed differently or when only one side has collapsed, some patients hesitate to undergo revision surgery due to concerns about re-treating the entire area. What is important in eye reconstruction cosmetic surgery is not excessively broad revision surgery, but a precise approach to identify collapsed anatomical balance and restore only the necessary areas. Sheone Plastic surgery, which provides specialized care in eye reconstruction fields such as epicanthoplasty restoration, lateral canthoplasty restoration, double eyelid revision, and eye shape correction, uses 1:1 pre-surgery consultation to analyze each patient's lateral canthus inclination and tissue laxity from multiple angles before directing care toward applying only the necessary scope. However, since the results of all reconstruction surgery can vary depending on individual tissue condition and degree of deformation, it is recommended to confirm a treatment plan suitable for you through consultation.
Frequently Asked Questions (FAQ)
Q. Can lateral canthoplasty revision be performed on only one side while achieving bilateral eye symmetry?
When deformation occurs only on one side or when left-right asymmetry is distinct, an approach of restoring only the deformed eye using the normal eye's form as reference can actually be a more refined method of symmetry correction. However, applicability may vary depending on individual eye condition, requiring prior diagnosis.
Q. Which should I choose between preservation restoration and single-side restoration?
If eye size reduction is to be minimized, preservation restoration can be considered; if grey line reconstruction and asymmetry relief are the highest priority, single-side restoration can be considered. Since both approaches have varying suitability depending on tissue condition and degree of deformation, it is advisable to decide through consultation with a specialist.
Q. Is unilateral restoration possible if eye tissue is weak and thin?
Unilateral restoration itself can be attempted even when tissue is weak or thin, but it can affect suturing strength and recovery speed, requiring careful evaluation of tissue condition beforehand. In such cases, it is recommended to design the surgical scope and method even more carefully.
Q. How long is the recovery period after surgery?
Suture removal generally occurs between 7-10 days, and approximately 2-3 months are reported to be required for overall stabilization of eye tissue and scars. However, recovery speed may vary among individuals.
Q. Is there a risk of new asymmetry developing during unilateral restoration surgery?
If the suturing vector is not precisely adjusted based on the angle and curve of the opposite normal eye, there is a possibility that new asymmetry may actually develop. For this reason, thorough consultation with medical professionals with extensive clinical experience in eye reconstruction and customized design must be preceded.
Treatment results may vary depending on individual health conditions, so consultation with a specialist is essential.