The lateral canthal tendon anchors the orbicularis oculi muscle to the lateral orbit. Attenuation of this lower lid suspending mechanism due to aging, dehiscence, or post-blepharoplasty could lead to lower eyelid malposition. This could, in turn, result in significant adverse sequelae such as ectropion and lagophthalmos. The degree of laxity of the lower eyelid could be established pre-operatively via snap test and lid distraction test. Patients with a negative vector profile whose cornea projects beyond their infraorbital rim or those demonstrating lid laxity would benefit from a lower eyelid tightening procedures especially when undergoing transcutaneous lower eyelid blepharoplasty. Lateral suspension canthopexy is an easily performed adjunctive procedure that could circumvent the occurrence of lid malposition in these patients.