Let's first talk about what the canthal tilt actually is.
It's the angle between your inner (medial) and outer (lateral) canthus. A positive canthal tilt is ideal and it won't look feminine. A negative canthal tilt on the other hand will look tired or sad, which is obviously not ideal.
So how do you change it?
Spoiler: Bone structure controls the tilt illusion more than you think.
You can tighten the ligaments all day with a canthoplasty. But if your infraorbital rim is recessed, your lateral canthus won't have any support.
It drags down over time. Basically if the bone is flat, your tilt will be flat.
Strong infras are the most important factor
For basically anything in regards to eye area aesthetics. Strong infraorbitals give you better undereye support, a more positive canthal tilt, less scleral show and many other halos.
Get infraorbital implants if you lack that important bone.
Cope
If your eye is sitting in front of the cheek instead of above it, your lateral canthus will appear lower even if your ligaments are perfect.
This is why filler/canthoplasty alone doesn’t work.
You need to build the shelf/bone first.
Examples
