Dr. Esin Özlem Atmış
Almond Eye Surgery (Canthoplasty / Fox Eye)
A subtle change to the outer corner of the eye, planned with eyelid support, the bony orbit and the brow in mind.
Facial surgery · Outer corner of the eye
A small change in angle needs a careful plan.
“Almond eye” or “fox eye” surgery changes the shape and tilt of the outer corner of the eye (the lateral canthus). In a lateral canthoplasty the tendon at the outer corner is released and fixed in a new position, which can lengthen the eye opening and adjust its slant.1,2
When the lifted look you want comes mainly from the tail of the brow and the temple, a lateral brow or temporal lift may suit you better than changing the eyelid corner.3 Complications and unsatisfactory results after cosmetic canthoplasty are not rare, which is why the decision is made carefully.2
In short
- The outer corner of the eye is released and re-anchored; the eye opening and its slant can change.1
- Anatomy decides suitability: eye prominence, the bony orbit and lower eyelid tone all matter.1
- Deep-set eyes or a lax lower eyelid raise the risk of an unnatural shape or eyelid problems.1
- Stitches out at five to seven days; most swelling settles within a month; the scar may stay pink for two to three months.1
- Plan five to seven days in Istanbul.
What almond eye surgery changes
The outer corner of the eye is held by a small tendon attached to the inside of the bony eye socket. Lateral canthoplasty combines a small incision at the corner, release of this tendon and its re-fixation (canthopexy) at a planned height and position.1 A canthopexy on its own tightens or repositions the corner without fully releasing it, and is used for smaller changes.
| Where the change is wanted | What is usually considered |
|---|---|
| Angle and length of the outer eye corner | Lateral canthoplasty or canthopexy1 |
| Tail of the brow and temple | Lateral brow or temporal lift; see brow lift |
| Excess upper eyelid skin | Eyelid surgery |
| Hollow under the eye, flat cheek | Endoscopic midface lift or volume |
Thread-based “fox eye” lifts are a different, non-surgical approach and are not covered on this page.
Who it suits, and who it does not
Outcomes depend strongly on anatomy. Published experience suggests better results when there is enough space between the outer corner and the bony rim of the socket and when the eye is not deep-set; results are less predictable with a sunken eye, a small bony orbit, a downward-slanting outer corner or heavy upper eyelid skin covering the corner.1
Before changing the corner of the eye, the eye surface, tear production and lower eyelid tone are checked. Dry eye and earlier eyelid surgery change the plan.4
Before surgery: blood thinners, supplements and smoking
Bring a written list of every medicine, injection and supplement you take, including doses. The table shows what usually happens; it is not an instruction to stop anything yourself. Blood thinners protect against stroke and clots, so any pause is agreed with the doctor who prescribed them.5
| Medicine | What usually happens before planned surgery |
|---|---|
| Warfarin | Usually stopped about five days before surgery; some patients need a temporary heparin injection plan.5 |
| Apixaban, rivaroxaban, edoxaban, dabigatran | Usually paused one to two days before, depending on bleeding risk; dabigatran needs longer when kidney function is reduced.5 |
| Clopidogrel, ticagrelor, prasugrel | If the cardiologist agrees, usually stopped about 5, 3 to 5, and 7 to 10 days before respectively. After a recent coronary stent, planned surgery is often postponed.5 |
| Aspirin | Often continued when it is taken to protect the heart; the decision is individual and made with your prescribing doctor.5 |
| Ibuprofen, naproxen and similar painkillers | Increase bleeding and are usually avoided before surgery; paracetamol is the usual alternative.4 |
| Vitamin E, ginkgo, garlic, ginseng and other supplements | Can increase bleeding; usually stopped at least two weeks before, sometimes three.6,7 |
| Weight-loss or diabetes injections (GLP-1 medicines such as semaglutide or tirzepatide) | Most people can continue them, but the anaesthesia team must know. Surgery may be postponed during dose increases or if you have nausea or vomiting; some patients need a liquid diet for 24 hours before.8 |
Bleeding disorders. Tell us at the first contact if you have a diagnosed bleeding disorder (for example von Willebrand disease or haemophilia), a low platelet count, liver disease, or a history of unusual bleeding after tooth extractions, operations or with periods. Blood tests and a haematology opinion come before any surgical plan. Some people are better served by not having elective cosmetic surgery at all.
Blood pressure and diabetes. Poorly controlled blood pressure or diabetes increases the risk of a collection of blood under the skin (haematoma) and of poor healing; both should be well controlled before surgery.7
Smoking and nicotine. Stop all nicotine, including vapes, patches, gum and snus, at least three to six weeks before surgery and for three to six weeks afterwards. Nicotine narrows small blood vessels and raises the risk of wound problems and skin loss; if you relapse, tell us, because postponing is safer.9
The operation
Through a short incision at the outer corner, the tendon is released and fixed to the inside of the bony rim at the planned height. Fixing it inside the socket matters: fixation in the wrong plane can make the lower eyelid turn outwards.1 The procedure is usually done under local anaesthesia with sedation, and it can be combined with a brow lift or eyelid surgery.
Recovery and risks
| Time | What is typical |
|---|---|
| 5–7 days | Stitches removed1 |
| Up to 3 weeks | Redness and swelling of the white of the eye mostly resolve; avoid saunas, pools, contact lenses and rubbing the eye1 |
| 1 month | More than 90% of the swelling has settled1 |
| 2–3 months | The small scar at the corner fades from pink1 |
Risks include asymmetry, an unnatural or rounded corner from scar contraction, a lower eyelid that turns outwards, visible red lining of the eyelid, loss of lower lashes, a visible scar at the corner, partial return towards the old shape and the need for revision.1,2 Temporary blurred vision and watering are common after any eyelid surgery; serious vision problems are rare and need urgent care.4
Travelling to Istanbul for almond eye surgery
Many patients travel from other cities or countries. A clear plan makes the trip calmer and safer:
- Online consultation first: most international patients start with an online consultation. Send your concern, your medical history, your medicines and a few clear photos through the channel the practice arranges, before you book flights.
- Arrive at least one day before surgery: the anaesthesia assessment and the final examination take place before the day of the operation.
- Hospital stay: usually a same-day procedure; when combined with other surgery under general anaesthesia, one night is planned and a second night is optional.
- Time in Istanbul: plan five to seven days, until the stitches are removed.1
- Follow-up: reviews are planned at 1 month, 3 months, 6 months and 1 year. They can be done online if you live abroad; you will know whom to contact for urgent questions after you return home.
Dr. Atmış and the periorbital region
Op. Dr. Esin Özlem Atmış is an ENT and facial surgeon in Istanbul. She completed her specialist training in otorhinolaryngology at Ankara University Faculty of Medicine in 2014 and is a member of the Turkish Facial Plastic Surgery Association. She is one of the congress presidents of Face Bosphorus 3 (Istanbul, April 2026), a meeting on facial anatomy and medical practice. At Face Bosphorus 2025 she gave an opening talk and chaired sessions on the upper face and periorbital region, biostimulators and whole-face assessment; she was a listed speaker at Face Minima 2025, and at the 4th Congress of European ORL-HNS in Barcelona (2017) she chaired sessions that included facial anatomy. Details are on her scientific activities page.
Changing the angle of the eye is a periorbital decision, the area she chaired sessions on at Face Bosphorus 2025. She often recommends a smaller change than the one first requested, or a brow-based solution, when the eyelid corner itself is not the cause.
Her approach starts with understanding the concern before discussing an operation: what has changed, how it affects you, and which structures are actually responsible. The aim is a proportionate plan that keeps your expression and character, which sometimes means a smaller procedure, a different order of treatment, or no surgery. Besides Turkish, she speaks English and Italian.
Frequently asked questions
How long does the change last?
It is a structural change designed to last when the tendon is fixed securely. Partial relapse or asymmetry can still occur and may need revision.1,2
Is it the same as a thread fox eye lift?
No. Threads are a temporary, non-surgical technique; canthoplasty changes the tendon at the corner of the eye.
Will my vision be affected?
Blurred vision and watering can occur temporarily. Serious vision problems are rare and need urgent assessment.4
When can I wear contact lenses?
After about three weeks, once the corner has healed.1
Who should not have it?
People with deep-set eyes, a small bony orbit, a lax lower eyelid or untreated dry eye may get an unpredictable or unnatural result.1,4
Can it be combined with eyelid surgery or a brow lift?
Yes. Combining them is often more natural than changing the corner alone.
Clinical references
- Chae SW, Yun BM. Cosmetic lateral canthoplasty: lateral canthoplasty to lengthen the lateral canthal angle and correct the outer tail of the eye. Arch Plast Surg. 2016;43(4):321-327.
- Kim YJ, Lee KH, Choi HL, Jeong EC. Cosmetic lateral canthoplasty: preserving the lateral canthal angle. Arch Plast Surg. 2016;43(4):316-320.
- Raggio BS, Winters R. Endoscopic Brow Lift. StatPearls, NCBI Bookshelf (updated 2025).
- Mayo Clinic. Blepharoplasty.
- Perioperative management of antithrombotic medications: guidelines from the American College of Chest Physicians (summary in Am Fam Physician, 2023).
- American Society of Anesthesiologists. Herbal and dietary supplements and anesthesia (patient leaflet).
- Mayo Clinic. Face-lift.
- American Society of Anesthesiologists. Multi-society guidance on GLP-1 receptor agonists before elective surgery (2024).
- American Society of Plastic Surgeons. How nicotine sabotages plastic surgery.
This page is general information, not a personal diagnosis or treatment recommendation. Medicines must never be stopped without the advice of the doctor who prescribed them. Seek urgent medical care for heavy bleeding, rapidly increasing swelling, breathing difficulty, chest pain or sudden vision changes after surgery.
Start with a careful, honest consultation.
A consultation is not a commitment to surgery. It is where your concern, your anatomy and your health are looked at together.