Cat Eye Surgery (Canthoplasty)

Key Takeaways

• Canthoplasty or cat eye surgery is a cosmetic surgery done to improve the shape of your eyes for a more youthful and attractive look.
• It involves reshaping the lateral canthus or the outer corner of your eye where the lower and upper eyelid meet.
• A good candidate for cat eye surgery must be in good health and have realistic expectations about the results. 
• Canthoplasty is performed in a clinic or your surgeon's office and can take about one to two hours to complete.
• Your doctor will provide post-op care instructions to help you take care of the incision area and avoid complications.
• Canthoplasty may be performed alongside other eyelid surgery such as canthopexy and blepharoplasty. 

What is Cat Eye Surgery (Canthoplasty)?

Canthoplasty or cat eye surgery is a cosmetic eyelid surgery that reshapes your eyes for a more youthful and attractive look.

Many believe that cat eye-shaped eyes are attractive and seek canthoplasty to achieve precisely that.

The procedure involves reshaping the lateral canthus. The lateral canthus is the outer corner of your eye, where the lower and upper eyelids meet to form a V-shape.

Cat eye surgery makes the canthus appear raised, larger, and brighter. Just like a cat's eyes, as the name suggests.

You may hear some doctors refer to the procedure as cat eye lift surgery. 

However, not all canthoplasty patients aim for attractive eyes. The procedure can treat ectropion, a condition characterized by lower eyelids that are turned outwards.

People with ectropion are prone to eye infections and other vision complications.¹ This is due to overexposure of the eye to dust, debris, and dry air.

Artificial tears can help manage the condition. But severe ectropion may require surgery such as canthoplasty to restore the integrity of the eyelids.

Canthoplasty should only be performed by a highly-skilled oculoplastic surgeon.

Who is a Candidate? 

During an initial consultation, your eye surgeon will examine you to ensure the procedure is suitable.

Generally, you'll qualify for cat eye surgery if you:

• Have drooping or sagging eyelids due to age, genetics, or lifestyle
• You're in good physical health
• Have no pre-existing medical issues that may interfere with recovery
• Have adequate knowledge of the procedure and expected results
• You have realistic expectations
• Are not taking certain medications, such as blood thinners

You don’t qualify for cat eye surgery if:

• You have underlying health conditions that may affect healing
• You're taking blood thinners that may lead to excess bleeding
• You have unrealistic expectations
• You cannot follow the post-op care guidelines

How Much Does Cat Eye Surgery Cost?

According to a 2020 survey by the American Society of Plastic Surgeons (ASPS), the average cost for cat eye surgery is about $4,120.²

This price may vary based on your location, available facilities, and surgeon's experience.

Since a cat eye lift is an elective cosmetic procedure, your insurance will not cover it. However, you may be eligible for some coverage if it’s required to correct a medical problem such as chronic dry eyes.

Talk to your surgeon about pricing before committing to the surgery. Some surgeons may offer financing options like payment plans. 

Canthoplasty Procedure: What to Expect 

Cat eye surgery is an outpatient procedure, meaning you'll go home immediately after surgery. It's primarily performed using local anesthesia and intravenous (IV) sedation to help you relax.³

If a more complex and invasive procedure is needed, your surgeon will use general anesthesia to make you sleep.

The procedure takes two hours or less.

Before Surgery (Preparation) 

Just like any surgery, preparation is key. 

Your surgeon will instruct you to do the following:

• Stop taking blood-thinning medication such as ibuprofen (Advil), apixaban, edoxaban, Heparin, etc. They may cause over bleeding during surgery.
• Eat a light meal the night before surgery and don't eat or drink at least 6 hours before the surgery. This will help prevent the risk of aspiration (common during general anesthesia).⁴
• Take your essential medication, such as antihypertensives for blood pressure. This will help avoid complications such as high blood pressure during surgery.
• Avoid wearing makeup. Makeup contains chemicals irritants and is a breeding ground for bacteria.
• Rinse your face with only water and soap. Also, avoid applying lotion or face creams on the day of the surgery.
• Plan for reliable transportation to and from your surgeon's office. Your driving ability will be temporarily impaired after surgery.
• Have someone keep you company for a day or two after surgery to help in case of an emergency.

During Surgery (Steps)

Before cat eye surgery, your surgeon will evaluate your eyes again. Then they’ll cut the lateral canthal tendon and reposition or tighten it to achieve the desired eye shape.

The lateral canthal tendon is a connective tissue attaching the eyelids to eye muscles. It helps support the structure and function of the eyelid.⁵

Your surgeon will carefully make several incisions to detach the tendon, shorten it, and reposition it to achieve the cat eye appearance.

An experienced surgeon will hide the incision scar by cutting through the eye's natural crease. 

If your eyelids are just slightly sagging, your surgeon may recommend a less invasive procedure known as canthopexy. 

Canthopexy doesn't require detaching the lateral cantal tendon.⁶ Instead, it involves the placement of sutures to tighten the eyelid. Sutures are thread-like stitches used to repair minor cuts.

After Surgery (Recovery)

Once the surgery is complete, your ophthalmologist will stitch up the incision and dress it to prevent infection.

Your surgeon may prescribe ointment, steroid eye drops, and artificial tears to help with any pain or discomfort after surgery.

You will also use an eye shield for a few days. This helps prevent dust and debris build-up, as well as any possible trauma.

To ensure success in recovery, you must follow your doctor's post-op care guidelines, which may include:

• Resting your eyes. Take off from work or other commitments and keep your eyes rested. 
• Using an icepack on your eyes during the early days after surgery to ease the swelling.
• Maintaining good eye hygiene. The wound is prone to infection if not cleaned properly. A 3% hydrogen peroxide and warm water mixture works. Use it three times a day.
• Avoid rubbing, squeezing, or touching your eyes as this may interfere with the healing wound or cause infection.
• Avoid wearing your contact lenses for about two weeks to avoid too much strain on the healing tendons. 
• Avoid medication such as ibuprofen that may increase bleeding.
• Wearing protective eyeshields while outdoors or sleeping to avoid accidental injury or exposure to dust, pollen, and other irritants.
• Attending follow-up visits for close monitoring of the healing process.
• Wear sunscreen. Direct sunlight can affect the healing process and may cause enlargement or hyperpigmentation of your scar. Using sunscreen during recovery will prevent scar complications.

How Long Does it Take to Recover From Canthoplasty?

For most people, recovery after cat eye surgery may take about two to three weeks. Full recovery may take several more weeks.

Recovery involves three stages: bruising, swelling, and scar formation. The scars will disappear with time.

In addition, changes in your eye's appearance will become apparent after a few months.

Possible Side Effects 

Patients who undergo canthoplasty may experience the following side effects:

• Bruising
• Bleeding
• Blood clots
• Scaring
• Loose stitches
• Excess tearing
• Dry eyes
• Mild to moderate pain
• Swelling

You may also experience drowsiness, nausea, and vomiting from the anesthetics and sedatives used during surgery.⁷

Although bruising and swelling are common canthoplasty side effects, they usually disappear within a week.

Some patients may experience vision changes, but these are temporary.

Seek immediate medical attention if you notice severe pain, shortness of breath, chest pains, bleeding, or potential infection after surgery.

What are the Risks? 

The potential risks of cat eye surgery include:

• Excessive bleeding
• Poor alignment of the outer canthus⁸
• Conjunctival exposure
• Infections around the site of surgery

Canthoplasty vs. Other Treatments

Other eyelid treatments exist and may be confused with canthoplasty. These include blepharoplasty and canthopexy.

Blepharoplasty is corrective surgery for drooping eyelids (ptosis), commonly due to age.⁹ It removes excess skin, muscles, and fat from the eyelids, making the eyes appear younger.

Blepharoplasty can be performed alongside canthoplasty to improve results.

Blepharoplasty can also improve the results of other cosmetic surgeries, such as facelifts and brow lifts.

On the other hand, canthopexy is a simpler and less invasive form of canthoplasty used to treat mild eyelid defects. 

Canthopexy doesn't require your surgeon to detach and shorten the lateral canthal tendon, as in the case of cat eye surgery. Instead, they will place sutures to tighten the eyelid.

Canthopexy can also be done together with canthoplasty or blepharoplasty to improve results. Canthopexy alone, though, cannot achieve the slanted eye shape (cat eye shape).