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Almond Eye Surgery

Eyelid retraction refers to upwards displacement of upper eyelid or downward displacement of lower eyelid .  The white part of the eye is exposed superiorly or inferiorly.  It can be congenital (born with it ) or associate with some pathologies (eg thyroid eye disease) or proptosis (protruding eyes due to extreme short-sightedness or other pathologies such as tumor if it occurs unilaterally).

When the eyes is retracted upwards, it can give a surprised look which may not be that desirable.

When the eyes is retracted downwards, many may perceive it as sad, tired, withdrawn. In Korea, it is called sambaegan which may represent physical, physiological or spiritual unbalance. According to Chinese/Japanese medical face reading, it also represent imbalance in body and is claimed to be present in alcoholics, drug addicts and people who over -consume sugar or grain. (Source: wikipedia). Sometimes, it can also occur post lower eyelid blepharoplasty.

However, it is to emphasise that if it is not associate with pathologies (Eg thyroid eye disease/ proptosis), the lower eyelid retraction is just one part of variants of normal and should be recognised as it is. There is no necessary to have any correction or insecure feeling about it.

What is Almond eye Surgery?

One of the key part of this surgery is to correct negative canthal tilt.  Canthal tilt means the angle between the medial canthus (inner corner of the eye) in relation with the outer canthus.  Positive canthal tilt is medial canthus lower than the outer canthus .

Positive canthal tilt is lateral canthus 5-8 degrees above medial canthus. It is consistently associated with youthful and attractive faces.

Negative canthal tilt is commonly associate with a tired or sorrowful appearance.  It can also occur in advanced ageing.  Although its interpretation may subject to individual interpretation.

Also required is retractor recession. Be it on upper or lower and it requires highly skilled oculoplastic surgeon’s attention.

Pre Op: Lower eyelid bags with significant descent of mid cheek. There is a deep nasojugal fold.

Positive canthal tilt is associated with pleasant attractive appearance

 

Post op: reduced eye bags appearance and smooth lower eyelid-cheek junction. Patient looks much more refreshed.

Negative canthal tilt is associated with sad, depressed look.

Before and after photos

Pre op: Bilateral negative canthal tilt, scleral show inferiorly (sanpaku eyes/inferior eyelid retraction), which showed a sad and disinterested look.

Post op: lower eyelid bags has disappear (Results in one month)

Post op: bialteral positive canthal tilt, lower eyelid has lifted up.  A much engaging, interested and refreshing look.

Pre op: Lorem ipsum dolor sit amet, consectetur adipiscing elit

Post op: lower eyelid bags has disappear (Results in one month)

Post op: Lorem ipsum dolor sit amet, consectetur adipiscing elit

Post op: lower eyelid bags has disappear (Results in one month)

Post op: Lorem ipsum dolor sit amet, consectetur adipiscing elit

Pre op:  Bilateral bulging eyes.  This patient is very self conscious of his bulging eyes appearance.

Post eyebags removal: left lateral pose

Post Op:  No more bulging eyes!!! Lower eyelids had been lifted up and reduced whiteness in outer corner.  Noted  positive lateral canthal tilt.

Pre op:  Whiteness below both eyes.  Make one look less attractive and tired.

Post eyebags removal: left lateral pose

Post Op:  A combined ptosis surgery together with lateral canthoplasty make no more whiteness show under the iris (improve eyelid retraction appearance).

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