Eye Corner Lifting
Feminizing the eye shape by contemporary standards is to elevate the outer corner of the eye. This elevation specifically refers to having the outer eye corner is higher than the inner eye corner. At the least this alleviates a tired looking eye but females generally prefer a slight upturned outer eye corner. To reposition the outer eye corner higher a lateral canthoplasty technique is needed. (not a lateral canthopexy) The lateral canthal tendons need to released and moved up higher inside the lateral orbital rim. The most secure method in doing so is with transosseous holes for the suture fixation of the tendon to the bone. This is most conveniently done during a brow bone reduction or can be done independently using a small lateral upper eyelid incision. Emphasis is placed on elevating the outer eye corner for over correction as some settling will always occur.
In its most exaggerated form, sometimes called Cat Eye surgery, the outer eye corner is significantly elevated which is often combined with a tall of the brow lift creating . This creates a complete upward temporal sweep look to the outer eye area.
Infraorbital Augmentation
While not necessarily a gender feature, hollowing under the eyes is an undesired midfacial appearance. (infraorbital hollowing) Given its location under the eye it is not going to be improved by any effect of cheek augmentation. (unless a custom infraorbital-malar implant is used) Like cheek augmentation, treatment options include injectable fillers, fat injections and implants with the same advantages and disadvantages for each one of them. The difference in the infraorbital area from that of the cheeks is that the overlying soft tissues are thinner and contour irregularities are much more common with fillers and fat. In addition the removal of any filling material (semi-permanent fillers and fat) may be less problematic than that of the cheeks but still requires an open lower blepharoplasty to do so.. For these reasons hyaluronic-based synthetic fillers or infraorbital implants are often better treatments and more easily reversed. The options in permanent implants includes standard tear trough and custom made infrarorbital implants.
Dr. Barry Eppley
Indianapolis, Indiana