Canthoplasty and canthopexy are two procedures often confused. They are both procedures involving the lower eyelid, but whilst canthoplasty reshapes the eye, canthopexy provides additional support to the eye without actually changing its shape. These procedures are often performed in conjunction with a blepharoplasty or face lift. Canthoplasty can be used to help create an upward slant in the outer corner of the eyelid, elongate the lateral or outer aspect of the eyes, or to correct a drooping appearance. Canthoplasty is often requested for those wanting to create ‘catlike’ eyes, by Asian people wanting a more European eye appearance, or those who have developed an eye droop from aging or previous surgeries. In canthoplasty, an incision is made in the outer corner of the eyelid to access the canthal tendon. This incision is placed within the natural crease of the eyelid to minimise scarring. The lower canthal tendon is then cut and detached from the orbital bone. It is moved upward and tightened. Canthopexy aims to tighten the eyelid and improve lid position and shape. It is less invasive than canthoplasty, as in canthopexy the canthal ligament is simply tightened with sutures, rather than the canthal ligament being cut and reattached. The sutures provide stabilisation and reinforcement to the existing canthal ligament. It is not suitable for eyelids with a high level of droop, or those wanting to radically change the shape of their eyes.