Fig. 11. A. After a lateral canthotomy has been performed, the inferior crux of the stretched lateral canthal tendon is severed. B. The lateral canthal tendon is draped over the lateral orbital wall to determine the amount of lower eyelid tightening required. C. A stab incision is made through the superior portion of the lateral canthal tendon at its insertion. A double-armed suture is passed through the lateral extremity of the severed inferior portion of the lateral canthal tendon. The suture ends are brought through the previously made stab incision. D. The tightened lateral canthal tendon is sutured to periosteum.