Support of the lower eyelid with canthal suspension is a useful tool in the prevention of complications of lower blepharoplasty, particularly for eyelids with increased lower lid laxity, relatively prominent globes, and negative vector configuration of the eyelid-cheek junction. Management options include canthopexy, orbicularis sling, and modified canthoplasty. The most conservative option is canthopexy, which supports the lower eyelid over the short or long term. The orbicularis sling technique avoids surgery around the lateral canthus, but may not be suitable for some cases. Canthoplasty is generally reserved for more marked laxity, which is less common in patients seeking aesthetic blepharoplasty.