49. Elastic Canthopexy
KEYWORDS: Elastic canthopexy, eye elongation, round eyes, Elasticum suture, Jano needle
Lateral elastic canthopexy is a new Elastic Plastic Surgery procedure that enables round eyes to be elongated without operating on the canthus.
Elongating the eyes gives the patient a more youthful, fascinating look.
A dermographic pen is used to draw a straight line from a point 5 mm from the external canthus to the hairline. This line constitutes the lower side of an Isosceles triangle. Local anesthesia is carried out along the implantation pathway of the elastic thread (Elasticum EP4).
We designed this procedure because we realized that rejuvenating the eyes was an extremely important part of rejuvenating the patient's look. The operating technique is simple.
A 2 mm incision is made at the hairline. A Klemmer is used to create a deep cavity in which the knot of the thread will be lodged. The two-tipped Jano needle passes through the temporal fascia, where it anchors the elastic thread that forms the short side of the triangle.
The Jano needle is partially extracted; it is then rotated and travels through the superficial subcutaneous tissue in the direction of the canthus. At a distance of a few millimeters from the canthus, the two-tipped needle emerges until less than 5 mm of the posterior tip remains in the tissues. The apex of the tip is now shifted laterally by a few millimeters, in order to achieve a firmer anchorage in the lower lateral retinaculum. After traveling through the superficial subcutaneous tissue, the two-tipped needle emerges from the small skin incision.
The two ends of the elastic thread are placed under tension and knotted. The traction exerted acts on all the tissues lying within the triangle. Elastic canthopexy is complete and will remain stable over time, unless there is no structural failure of the tissues.
The patient's eyes have been elongated without having to operate on the canthus. The intervention is simpler and less invasive to those of traditional canthopexy procedures, in which the canthus is fixed to the periosteum of the orbital margin.
Capurro S. (2020): Elastic Canthopexy. CRPUB Medical Video Journal. Elastic Plastic Surgery section. www.crpub.org.
If all the tissues within the triangles are placed under traction, does this mean that elastic canthopexy not only elongates the eye, but also draws the periocular tissues laterally?
Exactly. It is like placing three fingers on the temples and exerting tension laterally on the eyes. Elastic canthopexy is much simpler, more effective and does not present risks of canthoplasty and canthopexy. It also affects all the lateral tissues to the cantus.
Can elastic canthopexy be performed at the same time as face-lifting procedures?
Yes. It can be performed on its own if the patient only wants to elongate or reshape the eyes. However, when we perform elastic MACS lifting, we often suggest rejuvenating the eyes by means of elastic canthopexy during the same operation. Elastic canthopexy can also be carried out during lifting of the cheeks without dissection, and during lifting of the temples and eyebrows. Our eyes tend to become round with aging; elongating them makes them look younger and more fascinating. After elastic cantopexy we frequently perform upper blepharoplasty and if is necessary elastic lifting of the eyebrows. Of course, when we exploit the incision used for MACS lifting, we cannot slant the eyes to a great extent; if the patient wants "cat-like" eyes, a small access (even of only 2 mm) has to be made in a higher position. In this case, the thread is fixed to the retinaculum immediately under the canthus.
What are the difficulties of the intervention?
To have a permanent result it is necessary that the tip of the Jano needle must cross the lateral retinaculum. The tip must pass through this more resistant fibrous tissue.
What precautions should be taken?
In this region, the pathway of the needle is not superficial; the thread should therefore be wetted before it is implanted. We use 10% glycerol in physiological solution, which is available in all pharmacies in Italy, or mannitol. The eyes to become round with aging; elongating them makes them look younger and more fascinating.
No comments yet