The Ultimate Guide to Canthal Fixation in New York City in 2025

In the vibrant and competitive world of cosmetic and reconstructive surgery, canthal fixation has emerged as a crucial procedure for addressing various eyelid conditions and enhancing facial aesthetics. New York City, a global hub for medical innovation and expertise, is home to some of the top professionals and facilities specializing in canthal fixation. This article will delve into the top 4 places for canthal fixation in New York City, providing in - depth insights into the procedure, its benefits, and what to expect from each of these leading institutions.

Understanding Canthal Fixation

Canthal fixation is a surgical procedure that focuses on the canthi, the corners of the eyes. The two main types are medial canthal fixation (involving the inner corner of the eye) and lateral canthal fixation (involving the outer corner of the eye). These procedures are used to correct a range of issues, including lower lid laxity, ectropion (turning out of the eyelid), entropion (turning in of the eyelid), and canthal dystopia (abnormal positioning of the canthus).

Anatomy of the Canthi

The canthi are complex structures with important underlying anatomical components. The medial canthus is formed by the confluence of the upper and lower eyelid margins. The medial canthal tendon is a key structure that connects multiple components such as the septum orbitale, lockwood’s ligament, and the levator aponeurosis. It plays a crucial role in the shape and function of the lower eyelid, contributing to the lacrimal pump mechanism and preventing ectropion. The lateral canthus is the point where the upper and lower eyelids meet at the outer corner of the eye. The lateral canthal tendon attaches to the periosteum of the inner lateral orbital tubercle, helping to fixate the position of the eyelids and maintaining the proper shape and health of the eye.

Indications for Canthal Fixation

• Functional Indications: Canthal fixation can address functional problems such as exposure keratopathy (damage to the cornea due to inadequate eyelid closure), epiphora (excessive tearing), and issues related to improper eyelid blinking and protection of the ocular surface. These problems can be caused by previous surgeries, aging, hormonal conditions, congenital defects, trauma, or paralysis.
• Cosmetic Indications: For patients seeking cosmetic improvements, canthal fixation can alter the shape and position of the canthi to achieve a more youthful, attractive appearance. For example, in Asian populations, lateral canthal fixation may be used to lengthen the palpebral fissure and change the angle of the lateral canthus, giving the eyes a larger and brighter look. In Western populations, it can help correct age - related canthal distortion, such as a downward drift of the lateral canthus.

The Top 4 List of Canthal Fixation in New York City

1. Cangello Plastic Surgery

Dr. David L. Cangello at Cangello Plastic Surgery is a leading plastic surgeon in New York City. He has a reputation for achieving superior, natural - looking results through his artistic insight and surgical precision. Dr. Cangello offers blepharoplasty, which often includes aspects of canthal fixation. His approach to eyelid surgery focuses on creating an uplifted and natural look, smoothing puffy under - eye bags and excess skin on the eyelids that can make a person appear tired or sad.

What to Expect

• Personalized Consultation: Dr. Cangello takes the time to understand each patient's unique goals and concerns. He will conduct a thorough evaluation of the patient's eye anatomy, medical history, and aesthetic expectations. This allows him to develop a customized treatment plan tailored to the individual's needs.
• High - Quality Results: With his extensive experience and artistic eye, Dr. Cangello is known for producing results that are both aesthetically pleasing and functional. His eyelid surgeries aim to enhance the patient's natural beauty while ensuring proper eyelid function.
• Exceptional Patient Care: The entire team at Cangello Plastic Surgery is committed to providing a comfortable and supportive environment for patients. From the initial consultation to the post - operative follow - up, patients can expect personalized attention and high - quality care.

2. Antell Plastic Surgery

Dr. Darrick E. Antell is a top plastic surgeon in New York City with over twenty years of experience and more than ten thousand procedures to his credit. He offers a comprehensive range of facial procedures, including eyelid surgery which may involve canthal fixation. Dr. Antell combines meticulous surgical skills with the latest and safest medical technologies, and the distinct eye of an artist.

What to Expect

• Advanced Techniques: Dr. Antell stays at the forefront of medical advancements, using the latest techniques in eyelid surgery. This ensures that patients receive the most effective and safest treatments available.
• Holistic Approach: He takes a holistic approach to patient care, considering not only the physical aspects of the procedure but also the patient's emotional well - being. Dr. Antell and his team work closely with patients to manage expectations and provide support throughout the surgical process.
• Positive Patient Feedback: Many patients have left glowing testimonials about their experiences at Antell Plastic Surgery. They praise Dr. Antell for his ability to listen to their concerns, his professionalism, and the outstanding results he achieves.

3. Mount Sinai - New York, Division of Facial Plastic and Reconstructive Surgery

The division of facial plastic and reconstructive surgery at Mount Sinai is staffed by double - board - certified experts in facial plastic surgery. They specialize in enhancing, reshaping, and balancing the appearance of the face, including canthal fixation procedures.

What to Expect

• Multidisciplinary Team: Patients at Mount Sinai benefit from the expertise of a multidisciplinary team, including surgeons, advanced nurse practitioners, estheticians, and nurses. This collaborative approach ensures comprehensive care and optimal results.
• Minimally Invasive Options: Whenever possible, the surgeons at Mount Sinai offer minimally invasive surgical options for canthal fixation. These procedures reduce scarring and tissue disruption, leading to faster recovery times, shorter hospital stays, and fewer complications.
• State - of - the - Art Technology: With access to state - of - the - art technology and the latest advancements in the field, the surgeons at Mount Sinai can provide the highest quality of care. They are able to use the most advanced tools and techniques to achieve precise and effective results.

4. Top Surgery Specialists of NYC

Although Top Surgery Specialists of NYC is well - known for its gender - affirming top surgeries, they also have expertise in procedures related to the face and eyes, including aspects of canthal fixation. Their board - certified plastic surgeons are internationally known for providing natural - looking results and are committed to following the highest standards of care.

What to Expect

• Specialized Care: The surgeons at Top Surgery Specialists of NYC take a personalized approach to each patient, tailoring the surgical technique to the individual's unique anatomy and goals. They have experience in working with a diverse range of patients and are sensitive to the specific needs of each individual.
• Multidisciplinary Support: The practice offers multidisciplinary care, including referrals to a verified network of physicians and therapists experienced in trans - competent care. This comprehensive approach ensures that patients receive all the support they need throughout the surgical process and recovery.
• Quick Scheduling: One of the advantages of choosing Top Surgery Specialists of NYC is their ability to get patients on the calendar for surgery within a month of their consultation, which can be beneficial for those who are eager to undergo the procedure.

The Canthal Fixation Procedure

Pre - operative Evaluation

Before undergoing canthal fixation, patients will undergo a comprehensive pre - operative evaluation. This includes a detailed medical history to assess any comorbidities that may affect the surgery or anesthesia. The patient's medications and any conditions that may cause excessive bleeding, such as hypertension or the use of non - steroidal anti - inflammatory drugs (NSAIDs), will be evaluated. Patients will also be asked about previous symptoms of dry eye, as this can be a common post - operative issue.

A physical examination will be performed, focusing on the eyes. This may include a slit - lamp exam to analyze the corneal surface, assess for dryness, and check for punctal eversion or stenosis. A Schirmer test may be done to determine if there is a component of ocular surface disease. The margin - to - reflex distance (MDR) will be measured to assess for ptosis. Additionally, the surgeon will take note of any visible neoplasms, skin discoloration, or actinic damage to the area, as well as any facial asymmetry or deformities.

For lateral canthoplasty, measurements of the distance from the lateral canthus to the orbital rim and the degree of eye slant may be taken. Pre - operative imaging, such as a CT or MRI, may be used in cases of trauma, iatrogenic injury, or pathology that alters the normal architecture of the canthus.

Surgical Techniques

Medial Canthoplasty Techniques

• C - U Medial Canthoplasty: This technique is often used for patients with blepharophimosis - ptosis - epicanthus inversus syndrome (BPES). It aims to amend epicanthus and telecanthus. The surgeon will calculate the amount of tissue to be removed for ideal intercanthal distance, make specific markings on the patient's face, and then remove the appropriate skin and orbicularis muscle to expose the medial canthal tendon. The tendon is then shortened by folding in the excess and fixating it to the anterior lacrimal crest periosteum.
• Y - V Medial Canthoplasty: This procedure is used to shift or reinsert the medial canthal tendon to a proper location in cases of telecanthus. It involves making incisions, dissecting to the medial orbital wall periosteum, and using transnasal wiring to secure the tendon in the desired position.
• Medial Canthoplasty Repair for Canthal Rounding: When canthal rounding occurs after iatrogenic injury or trauma, this technique can be used. The anterior and posterior lamellae are separated, and new lid margins are created and secured with sutures. If there is lid laxity, it can be combined with a canthopexy.

Lateral Canthoplasty Techniques

• Dermal Orbicular Pennant: This technique is useful for patients who require canthal support or have had unsatisfactory results from horizontal shortening procedures. A flap is outlined laterally from the lateral canthus, the underlying dermis and orbicularis are incised to expose the lateral canthal tendon, and the dermal pennant is then secured with sutures.
• Inferior Retinacular Lateral Canthoplasty: This is a popular technique for both reconstructive and cosmetic canthoplasty. It involves making an upper eyelid crease incision, exposing the lateral canthal tendon, and then attaching the inferior component of the tendon to the inside of the lateral orbital rim at the level of the superior edge of the pupil.
• Lateral Tarsal Strip: This technique combines horizontal lid shortening and lateral support. It involves performing a lateral canthotomy and inferior cantholysis, separating the tarsus from the orbicularis oculi, and then attaching the tarsal strip to the periosteum inside the lateral orbital rim.

Post - operative Care

After canthal fixation surgery, patients will be given antibiotic, steroid, and artificial tear eye drops. Oral antibiotics and ophthalmic ointment may also be prescribed. Steroid eye drops should be tapered and discontinued once palpebral conjunctival swelling subsides.

Patients are advised to avoid impact to the surgery site and to not rub the eye for three weeks to avoid dehiscence. They should also refrain from activities that increase blood flow to the eyes, such as heavy lifting or bending. Swimming pools, saunas, and contact lenses should be avoided for three weeks, although face washing and light showers are permitted. Keeping the head in a raised position can help improve bruising and swelling. Sunglasses are recommended during the recovery period to protect from irritation resulting from sun and wind exposure.

Potential Complications

As with any surgical procedure, canthal fixation carries some risks. These include:

• Ectropion: This is the turning out of the eyelid, which can be caused by improper selection of the surgical technique or abundant lid laxity. Preventative measures, such as proper pre - operative evaluation, can help reduce the risk.
• Trichiasis: Misdirected eyelashes can occur after surgery, leading to irritation and corneal morbidity. Cryoepilation may be used to treat this complication.
• Chemosis: Swelling of the eyelids and conjunctiva is a common complication following eyelid surgeries. Most cases are self - limiting, but it can be exacerbated by the disruption of the lymphatic drainage system.
• Symblepharon: This is an abnormal adhesion between the bulbar and palpebral conjunctiva. It can occur if enough trauma is inflicted to the area during surgery.
• Corneal Erosion: Exposed suture material after surgery can lead to corneal erosion, which presents as foreign body sensation, photophobia, and painful, red, watery eyes. Treatment typically involves lubricating drops, antibiotics, and removal of the foreign material.

Conclusion

Canthal fixation is a significant procedure for addressing both functional and cosmetic issues related to the canthi of the eyes. In New York City, there are several top - notch institutions and surgeons available, including Cangello Plastic Surgery, Antell Plastic Surgery, Mount Sinai - New York's Division of Facial Plastic and Reconstructive Surgery, and Top Surgery Specialists of NYC. Each of these places offers unique advantages, from personalized care and artistic results to access to advanced technology and a multidisciplinary team approach.

If you are considering canthal fixation, it is essential to do thorough research, schedule consultations with multiple providers, and have open and honest discussions about your goals, expectations, and concerns. By choosing the right surgeon and facility, you can increase your chances of achieving the best possible outcome and enhancing your overall quality of life.

If you found this article informative, we encourage you to share it with others who may be interested in canthal fixation. You can also explore more related topics on our website to learn about other facial and cosmetic procedures available in New York City.