Do You Need Canthoplasty? Types, Who Needs It, and an At-Home Self-Check

When looking into double eyelid surgery, many people also start weighing canthoplasty (eye-corner opening surgery). It's easy to assume canthoplasty simply makes the eyes look bigger, but the type and direction of canthoplasty you need can vary depending on your current eye structure and proportions. Here, we cover when canthoplasty may be needed, the characteristics of each type, situations that call for careful consideration, and a simple self-check method.

Is Canthoplasty Necessary When Getting Double Eyelid Surgery?

[What we often hear at consultations] Do I have to get canthoplasty along with double eyelid surgery?
What's the difference between front, upper, back, and lower canthoplasty?
Is my eye shape suitable for canthoplasty?

Getting double eyelid surgery does not mean everyone needs canthoplasty as well.

Whether canthoplasty is needed should be judged not by eye size alone, but by examining the overall structure of the eyes, including the following:

• Width-to-height ratio of the eyes
• Distance between the eyes
• Epicanthal fold — the skin fold covering the inner corner of the eye
• Position and angle of the outer corners of the eyes

In other words, if it's difficult to achieve the desired eye shape with the double eyelid line alone, canthoplasty can be considered. However, depending on your current eye structure, double eyelid surgery alone may be enough.

What Are the Differences Between Front, Upper, Back, and Lower Canthoplasty?

Canthoplasty is classified into several types depending on which direction it aims to improve.

Canthoplasty 01 / 04 · Front Canthoplasty (Inner Corner · Inner Side)

This method adjusts the epicanthal fold covering the inner corner of the eye, improving the front part of the eye, which can look heavy or closed-off.

Canthoplasty 02 / 04 · Upper Canthoplasty (Inner Corner · Upper Side)

This method adjusts the upper direction of the inner corner of the eye. It may be performed after considering the shape of the inner corner and how it connects with the double eyelid line.

Canthoplasty 03 / 04 · Back Canthoplasty (Outer Corner · Horizontal)

This method widens the horizontal length of the eye by creating more space at the outer corner.

Canthoplasty 04 / 04 · Lower Canthoplasty (Outer Corner · Lower Side)

This method adjusts the outer corner downward, which can help change the angle and vertical width of the eye shape.

This is the key point

Since each type improves a different area, rather than choosing a type simply because you think “I want my eyes to look bigger,” it's important to first identify which part of your current eyes needs improvement.

Are There Eyes That Shouldn't Undergo Front or Back Canthoplasty?

Canthoplasty is not a procedure where you can open up as much as you want.

For example, with front canthoplasty, excessive opening should be avoided if the following apply:

• The eyes are already relatively close together
• The caruncle is already sufficiently exposed — the caruncle is the reddish tissue at the inner corner of the eye

The same applies to back canthoplasty. Because the structure behind each person's eye and the available space differ, it cannot always be expanded as much as you'd like.

Steps to Decide

Therefore, when deciding whether to have canthoplasty, it's important to check not only the eye shape you want, but also your current eye proportions and the space that can realistically be secured.

What Is Dual Canthoplasty?

Another term you'll often come across in canthoplasty consultations is dual canthoplasty. Dual canthoplasty generally refers to performing back canthoplasty and lower canthoplasty together.

Dual canthoplasty considers two directions together, and the extent needed varies depending on individual eye structure.

Back canthoplasty widens the horizontal direction of the eye, while lower canthoplasty adjusts the angle of the outer corner downward, allowing both the horizontal and vertical dimensions of the eye to be addressed together.

It may be considered for those who want to soften a heavy or closed-off impression, such as when the outer corners are upturned or the eyes are short in width. However, the degree needed still varies depending on individual eye structure.

A Simple At-Home Self-Check for Canthoplasty

So, can you check at home whether you need canthoplasty? Looking in the mirror and going through the steps below can serve as a helpful reference before your consultation.

1. Look in a mirror and gently pull the inner corner of your eye.
2. Gently pull the outer corner of your eye as well.
3. Check how the shape of your eye and its overall proportions change.

Please keep this in mind

However, pulling the skin by hand does not produce the same result as actual surgery. Skin and tissue condition and the structures around the eyes must be evaluated in person, so self-checks are best used strictly as a rough reference.

For Beautiful Eyes, Overall Balance Matters More Than “Opening Up” as Much as Possible

What matters in canthoplasty is not simply making the eyes as big as possible. Front, upper, back, and lower canthoplasty each change different directions, and even with the same procedure, the achievable range and expected results can differ from person to person.

In particular, the following factors should be reviewed as a whole:

• Distance between the eyes
• Extent of the epicanthal fold
• Caruncle exposure
• Width-to-height ratio of the eyes
• Position and angle of the outer corners of the eyes
• Double eyelid line

In summary

If you have a particular eye shape in mind, be sure to share it during your consultation. However, rather than deciding on a specific type of canthoplasty first, it's important to have a board-certified plastic surgeon assess your current eye structure and proportions, and then determine the procedure that's right for you while considering overall balance.

Frequently Asked Questions

Do I need canthoplasty when getting double eyelid surgery?

Getting double eyelid surgery does not mean everyone needs canthoplasty as well. Whether canthoplasty is needed should be determined not by eye size alone, but by examining the overall eye structure, including the width-to-height ratio, the distance between the eyes, the epicanthal fold, and the position and angle of the outer corners. Depending on your current eye structure, double eyelid surgery alone may be enough.

What's the difference between front, upper, back, and lower canthoplasty?

Each type improves a different area. Front canthoplasty adjusts the epicanthal fold covering the inner corner of the eye, while upper canthoplasty adjusts the upper direction of the inner corner. Back canthoplasty creates more space at the outer corner to widen the horizontal length of the eye, and lower canthoplasty adjusts the outer corner downward, which can help change the angle and vertical width of the eye shape.

Is my eye shape suitable for canthoplasty?

Canthoplasty is not a procedure where you can open up as much as you'd like. For example, with front canthoplasty, excessive opening should be avoided if your eyes are already relatively close together or the caruncle is already sufficiently exposed. The same goes for back canthoplasty, since the structure behind each person's eye and the available space vary. It's important to check not only the eye shape you want, but also your current eye proportions and the space that can realistically be secured.

What is dual canthoplasty?

Dual canthoplasty generally refers to performing back canthoplasty and lower canthoplasty together. It considers both the horizontal and vertical dimensions of the eye by widening the horizontal direction with back canthoplasty and adjusting the angle of the outer corner downward with lower canthoplasty. The extent needed, however, depends on individual eye structure.

Can I check at home whether I need canthoplasty?

Looking in the mirror while gently pulling the inner and outer corners of your eyes, and checking how the shape and overall proportions change, can serve as a helpful reference before a consultation. However, pulling by hand does not produce the same result as actual surgery, so self-checks should be treated strictly as a rough reference.

What to Expect at Your Consultation

Through Assessment and Consultation with a Board-Certified Plastic Surgeon,
We Help You Find the Right Procedure Together

• Consultations with board-certified plastic surgeons
• Detailed analysis of your individual eye structure and proportions
• One-on-one personalized consultation and surgical planning
• Safety and results as our top priorities

We carefully examine your individual eye condition and structure to help you find the most suitable surgical approach together.

Consultation and Booking Information

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This post was created by the clinic operator in accordance with Article 56(1) of the Medical Service Act, for the purpose of providing public-interest information. The images in this post are thumbnails and explanatory screens from a canthoplasty video produced by 1mm Plastic Surgery. The people appearing on screen are video subjects for explanatory purposes and are not patient photos for before-and-after comparison. The self-check methods introduced in this post are for reference only and do not replace a diagnosis. Each surgery's applicability, results, and recovery may vary depending on individual eye condition, and side effects may occur. Please check the details through a medical consultation.