A canthoplasty is a cosmetic procedure designed to enhance the outer angle of the eye, specifically addressing the lateral canthus. The goal of this procedure is to refine the eyelid shape and rectify issues such as sagging or asymmetry by tightening the supporting muscles or ligaments at the outer corner of the eye.


In recent years, canthoplasty has become known as Almond Eye Surgery or Fox Eye Surgery and there has been much speculation on who has undergone surgery to achieve a much-coveted upward slant to the eye.

Dr Nick Koutroumanos does not perform canthoplasty as a standalone procedure to change the shape of the eye, but regularly performs it as part of overall eyelid rejuvenation. He also utilises it in cases of revision blepharoplasty in patients who see him with poor cosmetic outcome from surgery elsewhere.

When planning an eyelid lift, a crucial aesthetic consideration is the positioning of the lateral canthus, as many patients feel that a noticeable downward tilt to the lids conveys a sad, aged, or fatigued appearance.

Dr Koutroumanos slightly elevates the lateral canthus compared to the medial canthus near the nose by lifting and tightening the tendon before reattaching it using sutures. This creates a more upward slant to the eyes and achieves a rejuvenated and harmonious eye contour.

There are several surgical techniques to rejuvenate the eyelids, and an oculoplastic surgeon is best placed to assess and execute surgery which balances aesthetics and eye function. An oculoplastic surgeon must undertake extensive training as an ophthalmologist before further training in oculoplastic surgery that focuses on the eyelids, eye sockets and facial structures around the eye and the brow. Recognising the uniqueness of each patient, Dr Nick Koutroumanos employs personalised techniques based on individual anatomy.

Sagging eyes treatment

Procedure at a Glance

Procedure time
1-2 hours

Local or General

Length of Stay
Day case

Up & Mobile
Same day

1 week

Back to Work
1-2 weeks

5 days

Post-op Care
Ice pack for first 2 days

On back, sleeping upright for 1 week

Resume Exercise
2 weeks

Full Recovery
4-6 weeks

Final Results
2-3 months

Canthoplasty FAQs

Dr Nick Koutroumanos will often combine a canthoplasty with a blepharoplasty for patients with sagging ligaments and tendons surrounding the eye.

Dr Nick Koutroumanos predominantly employs a technique that avoids skin cutting. In the rare event that an external incision is necessary, it will always be strategically positioned within the natural crease of the eye to minimise visible scarring.

Similar to the recovery after a blepharoplasty, expect some bruising and swelling following a canthoplasty. However, these effects should subside within one to two weeks. Dr Nick Koutroumanos will furnish you with comprehensive guidelines to facilitate a smooth recovery. Temporary changes in eyesight may occur for some patients, but normal vision typically returns swiftly.

Potential complications encompass eye asymmetry, noticeable scarring, infections, bleeding, and the formation of hematomas. Temporary eye irritation or sensitivity may be experienced. In extremely rare cases, vision may be affected. Nevertheless, when performed by an experienced oculoplastic surgeon like Dr Nick Koutroumanos, who meticulously evaluates your eye health at every stage, a canthoplasty is generally deemed a safe and effective procedure, blending aesthetic considerations with eye health.

While a canthoplasty can be undertaken as a standalone procedure, it is frequently paired with an upper and/or lower blepharoplasty or a brow lift for a more comprehensive enhancement.

Eyelid surgery expert

Oculoplastic surgeon London


Dr Nick Koutroumanos

Dr Nick Koutroumanos is a London-based Ophthalmic & Oculoplastic surgeon, with particular subspecialty expertise in ophthalmic plastic & reconstructive eyelid, orbital and lacrimal surgery.

His private practice, based at The Hospital of St John & St Elizabeth in St John’s Wood complements his work in charge of a large NHS oculoplastics practice at the Royal Free Hospital in Hampstead.

A qualified senior trainer and Royal College Examiner in ophthalmic plastic surgery, cataract surgery and general ophthalmology, he runs an Oculoplastics Fellowship training programme that is highly sought-after by both UK and international candidates.

Kind Words from Our Patients


A true perfectionist

Words are not enough to express my sincere gratitude for the care and dedication Dr Koutroumanos put into my journey. I felt safe and secure in his hands. This is someone who truly cares about outcome and ethics of practice. A true perfectionist. I would not hesitate to wholeheartedly recommend him.

100% worth it

I had surgery a few days ago with Dr Koutroumanos for congenital ptosis. It’s early days but I don’t think it’s too early to say the results will be life changing for me in terms of confidence levels. I struggled at school due to the condition and have learnt to live with it – that is until I saw the doctor who was reassuring from the start and has just done the best job. 100% worth it and amazing to know I was in such safe hands. I can’t thank him enough.

I’m really happy with my results

I’ve recently had a brow lift and blepharoplasty with Mr N Koutroumanos. The whole process from start to finish was handled professionally and each process was very informative. I’m still at the recovery stage, so far I’m really happy with my results. Highly recommend using Mr N Koutroumanos services.