ABSTRACT
As the incidence of periorbital and midface surgery has increased, so too has the need for canthal reconstruction. In 1952, Converse and Smith (1) first described medial canthoplasty for correction of canthal malposition in patients with complicated naso-orbito-ethmoid (NOE) fractures and medial orbital wall fracture malunion following midfacial trauma. Since that time, numerous authors have described techniques for both canthoplasty and canthopexy as integral components of periobital rejuventation and canthal reconstruction (1−48). Each technique has evolved to specifically address a variety of upper and lower eyelid pathology including malposition, laxity, ectropion, entropion, soft-tissue trauma, and underlying skeletal deformity. Reconstruction of the lateral canthal angle now plays an important role in rejuvenation of the aging midface, and becomes even more critical during secondary blepharoplasty, when initial attempts at lateral canthal stabilization have failed. Reconstruction of the medial canthus, while of less importance during facial rejuvenation, often requires skilled repair following trauma, cancer ablation, and certain congenital deformities.
