Temporary eyelid suspension suture

This is a niche approach, used to secure the lower eyelid margin in place to help prevent postoperative ectropion. It is useful when there is concern that postoperative edema could result in a downward pull on the lower eyelid during the postoperative period. It is not, however, to be used to correct ectropion that is apparent intraoperatively.

Usually, a 4-0 nonabsorbable monofilament suture is adequate for Frost suture placement.

1. 
   

   After the closure has been completed, the needle is inserted through the tarsus or just inferior to it.

   
   
2. 
   

   With a fluid motion of the wrist, the needle is rotated, taking a 3-mm bite.

   
   
3. 
   

   The needle is then reloaded and passed through the skin above the medial eyebrow, keeping the angle and placement of the lower lid in its anatomic position.

   
   
4. 
   

   The suture material is then tied off gently, forming a sling. Alternatively, the positioning above the medial eyebrow may be secured using adhesive strips (Figures 5-33A, 5-33B, 5-33C, 5-33D).