Double eyelidplasty, ptosis correction with epicanthoplasty are widely-performed surgeries in
Asians. However, patients with a narrow palpebral fissure or an up-slanting appearance tend to have
a slightly disappointing surgical outcome. In those patients, cosmetic lateral canthoplasty may be an
effective adjunctive procedure for lengthening the palpebral fissure in selected patient, but may have
limiting results on patients with a short palpebral fissure or severe up-slanting appearance. Lower
eyelid descent was previously recognized as a symptom of aging process or a complication of lower
blepharoplasty. In the present, many Korean women want large, round, and oval-shaped eyes. The
authors have introduced a lowering the lower eyelid via a transconjunctival approach to enlarge the
palpebral fissure in selected patients. A total of 441 Korean patients underwent lowering of the lower
eyelid via a tranconjunctival approach with or without lateral canthoplasty from 2005 to 2011. There
were 12 males and 429 female with age ranging from 19 to 44 years old. The procedure was composed
of transconjunctival incison and tucking procedure between lower eyelid retractor and lower
tarsal plate. The up-slanting lower eyelid shape was easily modified by the procedure in all cases.
Most patients were satisfied with the results. Mean follow-up period from 2 weeks to 4 years.
Postoperative conjunctival swelling and chemosis were spontaneously resolved within 2 or 3 weeks.
The lowering of the lower eyelid is a simple, effective and reliable method for selective patients.