Canthopexy and canthoplasty are very commonly performed with blepharoplasty, but can be useful on their own or in combination with fillers in mild cases of retinacular aging or lower-lid ectropion where you don't need or want a true, full-blown blepharoplasty.
In the canthopexy, the lateral canthal tendon is folded over and stabilized with a stitch, but not dispensed with.
The key to a successful canthopexy is to release the tarsal strap, which is relatively resistant to aging laxity and tethers the lateral canthus inferiorly.
Transnasal canthopexy has probably become the gold standard for medial canthal tendon repair in nasoethmoid orbital fractures.
Insufficient attention has been paid to the fact that the frontoethmoid suture line and the anterior ethmoid artery are not always an accurate guide to the skull base during transnasal canthopexy; at most, this problem has been mentioned only in passing in many literature reports and well-known textbooks.