Aesthetic Plastic Surgery

, Volume 36, Issue 1, pp 3–7 | Cite as

Lateral Canthoplasty Using the Mitek Anchor System

  • Sophie Bartsich
  • Kimberly A. Swartz
  • Henry M. Spinelli
Original Article



Lower-eyelid shape and position have important aesthetic and functional implications. While primary canthoplasty is generally a straightforward procedure, secondary canthoplasty can be considerably challenging. This is especially true in the setting of poor periorbital tissues and the resultant lack of a stable platform from which to suspend the canthus. We report the first use of the Mitek device in secondary lateral canthal procedures to remedy this common problem.


Twelve patients underwent a total of 19 revision lateral canthoplasties using the mini Mitek suture anchor system. All of the patients had had prior cosmetic and/or reconstructive surgery in the lateral canthal area with resultant canthal malpositioning. To correct this, suture anchors were placed into a 2-mm area of intact bone on the lateral orbital wall, and the lateral canthal tendon was resuspended into proper position.


In this series, there were no postoperative infections or patient reports of persistent discomfort at the anchor sites. All suture anchors remained in proper position postoperatively, and patients reported satisfaction with eyelid shape and function. Most of the patients reported resolution of their preoperative symptoms. Mean follow-up time was 24.2 months.


The Mitek suture anchor is an excellent tool for lateral canthoplasty in patients with significant periorbital scarring or suboptimal canthal positioning after multiple cosmetic surgery procedures. It is also a good option for patients with significant soft tissue damage owing to prior surgery, radiation, or trauma in the periorbital field. This technique can be performed quickly through small incisions and requires only a small amount of stable bone for tendon fixation. Results are excellent and the procedure has proven to be safe and effective in our series of patients.


Lateral canthoplasty Lower-lid position Mitek Anchor 



The authors declare that they have no conflicts of interest to disclose.


  1. 1.
    Spinelli HM (2003) Atlas of aesthetic eyelid and periocular surgery. Saunders, PhiladelphiaGoogle Scholar
  2. 2.
    Patipa M (2000) The evaluation and management of lower eyelid retraction following cosmetic surgery. Plast Reconstr Surg 106(2):438–453; Discussion 454–459PubMedCrossRefGoogle Scholar
  3. 3.
    Spinelli HM, Tabatabai N, Nunn DR (2006) Correction of involutional entropion with suborbicularis septal and lateral canthal tightening. Plast Reconstr Surg 117(5):1560–1567PubMedCrossRefGoogle Scholar
  4. 4.
    Okazaki M, Akizuki T, Ohmori K (1997) Medical canthoplasty with the Mitek Anchor System. Ann Plast Surg 38(2):124–128PubMedCrossRefGoogle Scholar
  5. 5.
    Spinelli HM, Forman DL (1997) Current treatment of post-traumatic deformities. Residual orbital, adnexal, and soft-tissue abnormalities. Clin Plast Surg 24(3):519–530PubMedGoogle Scholar
  6. 6.
    Spinelli HM, Jelks GW (1993) Periocular reconstruction: a systematic approach. Plast Recontr Surg 91(6):1017–1024CrossRefGoogle Scholar
  7. 7.
    Salgarelli AC, Bellini P, Multinu A, Landini B, Consolo U (2009) Tarsal strip technique for correction of malposition of the lower eyelid after treatment of orbital trauma. Br J Oral Maxillofacial Surg 47:298–301CrossRefGoogle Scholar
  8. 8.
    Hatoko M, Kuwahara M, Tanaka A, Yurugi S, Iioka H, Niitsuma K (2001) The correction of drooping eyelid due to cutaneous neurofibroma using Mitek anchoring system in a patient with neurofibromatosis (Von Recklinghausen’s disease). Plast Reconstr Surg 108(4):1089–1090PubMedCrossRefGoogle Scholar
  9. 9.
    Anderson RL, Gordy DD (1979) The tarsal strip procedure. Arch Ophthalmol 97(11):2192–2196PubMedCrossRefGoogle Scholar
  10. 10.
    Jordan DR, Anderson RL (1989) The lateral tarsal strip revisited. The enhanced tarsal strip. Arch Ophthalmol 107(4):604–606PubMedCrossRefGoogle Scholar
  11. 11.
    Antonyshyn OM, Weinberg MJ, Dagum AB (1996) Use of a new anchoring device for tendon reinsertion in medial canthopexy. Plast Reconstr Surg 98(3):520–523PubMedCrossRefGoogle Scholar
  12. 12.
    Goldenberg DC, Bastos EO, Alonso N, Friedhofer H, Ferreira MC (2008) The role of micro-anchor devices in medial canthopexy. Ann Plast Surg 61(1):47–51PubMedCrossRefGoogle Scholar
  13. 13.
    Okazaki M, Haramoto U, Akizuki T, Kurakata M, Ohura N, Ohmori K (1998) Avoiding ectropion by using the Mitek anchor system for flap fixation to the facial bones. Ann Plast Surg 40(2):169–173PubMedCrossRefGoogle Scholar
  14. 14.
    Dagum AB, Antonyshyn O, Hearn T (1995) Medial canthopexy: an experimental and biomechanical study. Ann Plast Surg 35(3):262–265PubMedCrossRefGoogle Scholar
  15. 15.
    Mathjssen IM, Roche NA, Vaandrager M (2005) Soft tissue fixation in the face with the use of a micro Mitek anchor. J Craniofac Surg 16(1):117–119CrossRefGoogle Scholar
  16. 16.
    O’Donnell BA, Anderson RL, Collin JR, Fante RG, Jordan DR, Ritleng P (2003) Repair of the lax medial canthal tendon. Br J Ophthalmol 87(2):220–224PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  • Sophie Bartsich
    • 1
  • Kimberly A. Swartz
    • 1
  • Henry M. Spinelli
    • 1
  1. 1.Division of Plastic Surgery, Department of SurgeryWeill Cornell Medical CollegeNew YorkUSA

Personalised recommendations