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Updated: Jun 21, 2026
A Standardized Surgical Technique for Tessier Medial Transnasal Canthopexy
Published on: January 23, 2026
Simple canthopexy used in transconjunctival blepharoplasty
1Oculo-Plastic Surgery Department of the 1st Infirmary of the Santa Casa da Misericórdia do Rio de Janeiro-Ophthalmology Service, Rio de Janeiro, Brazil. s.lessa@alternex.com.br
Purpose:
To describe a canthopexy technique without canthotomy that avoids release of the lateral canthal tendon for treatment of moderate lower eyelid laxity.
Methods:
A total of 316 patients underwent canthoplasty-blepharoplasty between December 1996 and November 2007. None of the patients had previously undergone any aesthetic surgical procedure. All cases showed moderate laxity of the inferior eyelid, and in 22 cases (7%), there was antimongoloid obliquity of several degrees. The lateral canthal ligament was attached to the periosteum of the orbital rim with nonabsorbable suturing material through the upper blepharoplasty wound. This technique follows the principle of canthopexy without canthotomy, avoiding the dissection of a submuscular tunnel and the release of the lateral canthal tendon.
Results:
Lower eyelid laxity was corrected in all cases. During the first 2 weeks, a greater tension of the lower eyelid and a slight upward slanting of the lateral canthus were observed. During this period, palpebral movement was slightly limited. In the third week after surgery, eyelid shape and canthal positioning had become completely normal.
Conclusions:
The technique described in this report greatly reduced surgical time and drastically lowered morbidity. It may be used in moderate lower eyelid laxity correction and in correction of moderate alterations of antimongoloid obliquity.
