Cosmetic eye surgery with lateral canthopexy for antimongoloid slant correction

Presentation of antimongoloid slant and its occurrence

A downward slant from the medial canthus to the lateral canthus of the eye is termed as an antimongoloid slant. It is the direct opposite of the mongoloid slant where the downward slant is from the lateral to the medial canthus of the eye. It can be idiopathic in nature or can occur as a part of a syndromic presentation including as a part of Treacher-Collins syndrome and Franceschetti syndrome. An eyelid surgery is performed to correct this.
Characteristics of the antimongoloid slant in eyes

Patients who have an antimongoloid slant to their eyes have no functional deficits to their eyes. It is only when patients are uncomfortable with the esthetic appearance of their eyes do they opt for surgical correction of this condition.

Subtle body language cues that can alter the very meaning of spoken words

Human communication can be divided into two components. One is verbal and the other is nonverbal cues. You would notice that when a person talks to another, they use their mouth to articulate the words, but special emphasis is laid to nonverbal communication through the use of hand movements and eye movements. Subtle differences brought about by nonverbal cues can change the entire tone of the communication even if the words remain unchanged.

Rationale behind opting for cosmetic eye surgery in the modern world

When one feels uncomfortable with the appearance of their eyes, this makes them feel very self conscious. This immediately leads to a sense of awkwardness that impedes effective communication. Communication is the tool through which we make a mark on the world around us. When this is affected by any factor, our very growth and integration into the community around us, whether at home or at the workplace is affected.

Care has to be taken by the surgeon to ensure that the functional integrity of the eyes is not compromised by this surgery. This is a completely elective eye surgery on the patient’s part to undergo this surgical procedure. Removing excess skin is performed in case of wrinkles in the skin in older patients in order to make the skin tauter.

Procedural description of corrective eye surgery

A form of brow lift is performed for this correction. Excess skin muscle if present is carefully excised before taking deep bites from the eyelid and eyebrow and suturing to the periosteum. Sagging skin under the eyes is also tightened as a secondary benefit arising from this procedure. The appearance of having droopy eyelids is corrected completely giving the patient a completely level gaze. Care should be taken to not impair vision in any way.

Lateral canthopexy surgery is one of the most commonly performed procedures of blepharoplasty in India. This is classified under brow lift surgery procedures. Cosmetic surgery is undergoing a boom throughout the world. India in particular is fast turning into a hub for cosmetic eye surgery, cosmetic nose surgery and overall cosmetic face surgery in the world.

Patient with antimongoloid slant is referred to our hospital for cosmetic eye surgery

The patient is a young man with idiopathic antimongoloid slant of the eye. He hated the way his eyes appeared. His marriage got fixed recently and he finally decided to get the slant corrected. He approached a local plastic surgeon at a cosmetic eye center in his hometown who referred him to our hospital for correction of his antimongoloid slant as we are a specialty center for cosmetic eye surgery in India.

Initial examination and treatment planning for the patient

Dr SM Balaji, cosmetic eye surgeon, examined the patient and ordered detailed biometric studies including measurements for the golden ratio. He explained to the patient that he needed a lateral canthopexy for correction of his antimongoloid slant. This is a procedure that has the approval of the American Society of Plastic Surgeons for the correction of antimongoloid slant.

The patient was in agreement with the treatment plan and consented for surgery. He explained that this procedure gave the best results for correcting the antimongoloid slant. The patient was informed that the decision might be made to remove excess skin if the need arose during surgery.

Surgical correction of antimongoloid slant of the eyes

Under general anesthesia, the patient was prepped and draped for surgery. Cosmetic eye correction surgery for antimongoloid slant of the right eye was performed first. An incision was made at the lateral canthus and extended outwards. The incision was then extended along the margins of the upper eyelid and also the lower eyelid.
A suture was passed through the edge of the lower eyelid and secured to the periosteum of the orbital margin. The incision was then closed in layers using sutures to ensure minimal scar formation. This resulted in bringing the medial and lateral canthal margins to the same horizontal plane.

Good esthetic results with symmetry of repositioned eyelids

The same procedure was next performed on the left eye. Perfect symmetry of the eyes was ascertained at the end of the procedure. Care was taken to ensure that the eyes were never dry during any portion of the procedure. General anesthesia was reversed and the patient recovered without incident after the surgery. The patient expressed complete satisfaction at the results of the surgery before final discharge from the hospital.

Surgery Video

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