Stable correction of antimongoloid deformity of the external canthus

The antimongoloid deformity comprises inferior dystopia of the lateral canthus. It causes a sad looking appearance, inferior scleral show and laxity of the lower eyelid. Many different procedures have been described to correct this deformity. We believe that a stable and lasting correction can be achieved using a coronal-approach subperiosteal mask-lift, combined with DMAS (Deep Musculo-Aponeurotic System) suspension of a temporo-masseteric anchor-flap (instead of a simple canthoplasty). If bony augmentation of the cheek bones is required, we use an autograft of cartilage of the concha of the ear. While this 'orthomorphic' procedure is primarily applied in esthetic cosmetic surgery, it can also be used to correct deformities in reconstructive surgery.