Lateral canthal tendon: the lateral anchor of the eyelid

The lateral canthal tendon is a fibrous band that joins the outer ends of the upper and lower eyelids and attaches them to the bone of the lateral rim of the orbit. It forms the outer corner of the eye and supports the lower eyelid, keeping it in contact with the eyeball. Its counterpart, on the nose side, is the medial canthal tendon.

What is its role in the gaze?

In many faces the outer corner sits slightly higher than the inner one, and this relationship is described in eye corner tilt, or canthal tilt. The lateral anchor is part of what holds that position. With aging, tissue laxity and loss of midface volume, the outer corner can lose support and the gaze looks more "tired" or droopy.

The lower eyelid also depends on this support. When the tendon loosens, the eyelid can lose tone, and the relationship between the eyelid and the cheek changes, which affects how the palpebromalar groove looks.

Why does it matter in HOF?

The outer corner area is delicate. It holds the orbicularis oculi muscle, the thinnest skin of the face and vessels that communicate with the ocular circulation. Procedures here, such as toxin for the outer-corner lines or approaches to the periorbital area, call for anatomical knowledge, conservative volumes and attention to signs of complications. The decision to treat and the technique belong to the licensed professional, according to the rules of their professional council in Brazil.

The canthal tendon and patient expectations

Patients sometimes ask to "lift the gaze" or "pull up the corner of the eye". It is worth explaining that the corner of the eye depends on deep structures and on midface support, and that harmonization is not the solution for every eyelid change. Cases of significant eyelid laxity usually call for a specialist assessment.

Points of attention

• Do not promise lifting of the corner of the eye with injectable procedures.
• Record the tilt in a standardized frontal photo, with the head level.
• Consider the whole: cheekbone, eyebrow and eyelid.

In Harmy

Marking the Tear Trough area in the app works on a nearby region, but Harmy does not alter the corner of the eye: the AI is instructed to keep expression and gaze, and the projection changes only the marked area. It does not simulate the tendon or the canthal tilt.

Also called: lateral canthal ligament, lateral palpebral tendon.