Almond eyes have slightly higher lateral canthus (outer corner of the eye) with the lower eyelids sitting just at the lower border of the iris (colored part of the eyeball) without any scleral show (white showing under the iris). Depending on the ethnicity, almond eyes are considered more beautiful and attractive and youthful. Many people (men and women) are blessed with naturally inherited almond shape eyes although that is not to say non-almond eyes cannot be beautiful. There are a variety of other factors that make eyes beautiful and ethnic variations exist. For patients who have rounded outer canthus and/or lower eyelids that are rounded and rest too low with sclera show (either inherited or as result of prior surgery “post-blepharoplasty eyelid malposition”), surgical improvement may be possible.
How to achieve almond shape eyes ?
First, almond eye surgery is not for everyone. The patient has to be realistic about his/her anatomy, eye shape, and goals. Prior eyelid surgery can complicate the problem and potential revision eyelid surgery.
For some, naturally looking almond eyes can be achieved through lateral canthoplasty, where the outer corner of the eye (lateral canthus) is repositioned and/or tightened. Lateral canthoplasty is a delicate procedure which should be done by an expert oculoplastic specialist. Dr. Taban has published a manuscript describing a minimal invasive technique to accomplish lateral cathoplasty, entitled “Aesthetic Lateral Canthoplasty.”
To learn more about cosmetic eye surgery, visit WebMD.com.
It is important to note that canthoplasty does not lift the lower eyelids by itself so it will NOT be enough as a stand-alone procedure to achieve natural looking almond eyes if the lower eyelids are also too low or vertically tight with lower eyelid retraction and scleral show. In these instances, additional procedures are necessary such as lower eyelid retraction surgery (with or without internal eyelid grafts) and/or midface lift to elevate the lower eyelids and release any vertical tension that will pull the lower eyelids and lateral canthus down if not properly addressed. In other words, what is needed to correct scleral show may be more than just canthoplasty. Dr. Taban has also published multiple manuscripts on lower eyelid retraction surgery to reduce scleral shwo entitled “Efficacy of thick Alloderm for Lower Eyelid Retraction Surgery” and “En-glove Lysis for … Lower Eyelid Retraction Surgery.”
Another rare confounding factor is if the patient has large protruding eyes, which can cause the lower eyelids to be pushed down. These patients may require additional procedures.
Almond eye surgery can be combined with other cosmetic eyelid procedures, if desired, such as blepharoplasty, eyelid ptosis surgery, and brow lift.
What to expect during and after almond eye surgery?
Almond eye surgery is performed under local anesthesia with or without conscious sedation. It is important for the patient to be able to open his/her eyes during surgery to achieve optimal outcome. As with most eyelid procedures, the patient goes home after surgery and is expected to have bruising/swelling for 7-10 days. Pain is mild and only for the first day, controlled by oral medication. Patient can resume normal activities after about a week although complete healing takes weeks to a few months.
As mentioned earlier, canthoplasty and almond eye surgery should be performed by an experienced oculoplastic surgeon to achieve natural results and avoid dramatic changes to your eye and facial appearance (such as over-pulled or “catwoman” appearance). Achieving symmetry is also critical. Mehryar Ray Taban, MD is an experienced oculoplastic surgeon with expertise in cosmetic eyelid surgery and almond eye surgery. He has offices in greater Los Angeles area (Beverly Hills and Santa Barbara).
Before (left) Lower eyelid retraction after previous aggressive lower blepharoplasty and 3 months after (right photo) revisional lower eyelid retraction surgery with midface lift, internal graft, and canthoplasty. Note the eyes are more almond shaped.
Before (left) lower eyelid retraction after previous aggressive lower blepharoplasty and 6 months after (right photo) after revisional lower eyelid retraction surgery with internal graft, midface lift, and canthoplasty with more almond shaped eyes.
Before (left) Middle age woman with right lower eyelid retraction after previous lower blepharoplasty, now needing revision cosmetic surgery. After (right) 4 months after right lower eyelid retraction surgery with internal alloderm graft, midface lift, canthoplasty, giving more natural almond shape eye appearance. (later she would also benefit from ptosis surgery and brow lift).
Young male, complained of inherited droopy lower eyelids with sclera show and sad looking eyes. He wanted more almond shape eyes. He underwent lower eyelid retraction surgery (without spacer graft) to create more almond eyes.
Young male, with inherited lower eyelid retraction and sclera show, underwent Almond Eye Surgery (lower eyelid retraction surgery with alloderm spacer graft, canthoplasty, tear trough implant) to give more attractive almond shaped eyes. Before and 3 months after surgery photos are shown.
Next, read about Revisional Eyelid Surgery.