The eye canthal tilt is the angle between the internal corner of the eyes (medial canthus) and the external corner of the eyes (lateral canthus). This tilt is a crucial section of periorbital aesthetics.
The eye canthal tilt can be negative, neutral, or positive. The canthus tilt is considered positive if the medial canthus angle ranges between 5 and 8 degrees below the lateral canthus. A negative canthal tilt is achieved when the medial canthus tilt varies between -5 to -8 degrees beneath the lateral canthus. A neutral tilt is when the medial canthus and lateral canthus are in line. A positive canthal tilt gives one a more attractive, sharper, and younger look.
Bueller (2018) found that positive canthal tilt gives men a more attractive, sharper, and younger look. “A positive canthal tilt is considered attractive in both men and women, with the lateral canthus positioned slightly superior to the medial canthus by approximately 2 to 4 mm. The angle of this tilt is slightly increased in women, at 2° to 4°, compared with men at 1° to 2°, and is considered a hallmark of a beautiful eye.” On the other hand, a negative eye canthal tilt makes men look tired, sad, and older.
Another study by Akşam & Karatan (2019) discovered that a positive eye canthal tilt is crucial for a younger and more attractive look. It is so powerful because of its relationship with the dimorphic and neotenic cue of the inclination of palpebral fissure.
In a detailed study by Volpe et al (2005), “There should be a slight incline or tilt to the intercanthal axis from medial to lateral, with an average value of 2.1 mm (+3 degrees) in men. This slight inclination cannot be overemphasized, because greater tilt to the intercanthal axis will give the male eyelids a feminine appearance.”
Akşam, E., Karatan, B. (2019). Periorbital Aesthetic Surgery: A Simple Algorithm for the Optimal Youthful Appearance. Plastic and reconstructive surgery. Global Open, 7 (5), e2217. https://pubmed.ncbi.nlm.nih.gov/31333949/
Bashour, M., & Geist, C. (2007). Is medial canthal tilt a powerful cue for facial attractiveness?. Ophthalmic Plastic & Reconstructive Surgery, 23 (1), 52-56. https://pubmed.ncbi.nlm.nih.gov/17237692/
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Shah, K., Lampley, N., Rossi, A., (2021). The Cosmetic Consultation . Essential Psychiatry for the Aesthetic Practitioner, (), –. doi:10.1002/9781119680116.ch7
Volpe, C. R., Ramirez, O. M., (2005). The Beautiful Eye. Facial Plastic, Surgery Clinics of North America. 13 (4), 493–504, https://pubmed.ncbi.nlm.nih.gov/16253836/
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Somenek, M., (2018). Gender-Related Facial Surgical Goals. Facial Plastic Surgery. 34 (05), 474-479. https://pubmed.ncbi.nlm.nih.gov/30296799/