Doctor, Can you make my eyelids longer?

In order to make the eyelid bigger, there are 2 factors to look at :

1. Vertical aperture

2. Horizontal aperture.

The horizontal aperture can be increased by lengthening the inner eyelid corner or outer eyelid corner. This blog will discuss about how to increase the horizontal aperture of the eyelid by increasing the length of the outer eyelid. You may read about the inner eyelid corner lengthening through Magic Epicanthoplasty in my earlier blog.

The outer corner fo the eye where the upper and lower eyelid joins is called the lateral canthus (figure 1). The tendon that holds the lateral canthus to the bone is called the lateral canthal tendon (figure 2).

Over time, the lateral canthal tendon become weak and sags as seen in older patients which may give rise to eyelid malposition. To correct this, the lateral canthal tendon is tightened through surgery to support the aging eyelids.

To widen the eyelids for cosmetic purpose, the lateral canthus can be modified surgically. Cosmetic lateral canthotomy is a simple procedure whereby the lateral canthus is split to widen the horizontal aperture of the eyelid. In this procedure, it is imperative that the lateral canthal tendon is not disrupted so as to maintain the anatomic relationship of the lateral canthus to the bony structure. Therefore, an additional of only 2-4 mm can be achieved with this procedure. This can be performed along with double eyelid procedure (whether suture or incision technique) and magic epicanthoplasty to achieve longer and wider eye that makes the eye appear larger, wider and more attractive.

As this is a delicate surgery, please make sure that you go to a qualified surgeon if you want to get this procedure done. The surgeon has to understand the anatomy of the eyelid and not compromise the inter-relationship of the lateral canthus and lateral canthal tendon.