Anyone hear of a lower eyelid lift with anchor to prevent the lid from sagging?

Question

Has anyone heard of a lower eyelid lift - incision through the lower lid and then having an anchor/surgical thread stitched on the lower lid? The anchor is supposed to hold the eye in place while it heals and to prevent the lid sagging. They do this by taping the surgical thread to the brow (from the lower lid). Kind of hard to explain but this was a recommendation from a plastic surgeon in NJ. I have never heard of this type of procedure but I wanted to know what other doctors think of it.

Kenneth D. Steinsapir, MD · Answer

Yes it is called a Frost suture.  Why does the surgeon need to place a Frost suture for lower eyelid surgery?  If you have had a prior eyelid surgery and need to have a pulled down lower eyelid corrected, a Frost suture makes a lot of sense.  If you have never had eyelid surgery, then the surgeon is telling you that they are concerned that your lower eyelid is likely to have a problem after surgery.  I would not ignore that warning.  It can mean one of two things: 1.  The surgeon is having lower eyelid complications after routine lower eyelid surgery and feels the need to use the Frost suture in an effort to avoid pulling the eyelid down (sadly a common issue with some surgeons). 2. You have a complicated negative vector lower eyelid.  If you have a complicated negative vector lower eyelid, I would recommend getting several surgical opinions before proceeding with eyelid surgery.

Stephen Weber MD, FACS · Answer

This is a Frost stitch. There are a number of technical ways to place and secure these but basically the suture helps hold your lower lid in a neutral (or sometimes overcorrected) position to prevent it from healing in a retracted position. They're only placed temporarily and usually very well tolerated. I don't routinely use these but actually placed two this morning for a revision lower eyelid case. My point is, this is not an unusual thing to perform. I hope this information is helpful.Stephen Weber MD, FACS

Steven J. Pearlman, MD, FACS · Answer

There are a number of different techniques we can use to reduce the chance of a lower eyelid pulling down after blepharoplasty. These sutures are sometimes placed externally as well and removed a few days after surgery. The external sutures are called Frost sutures. Internally sutures are used that are called canthopexy sutures. These make a sling to keep the eyelid tight during the healing period.

Matheson A. Harris, MD · Answer

You are referring to Frost sutures, which are used to put upward traction on the eyelids while they are healing. This helps them to not be pulled down be scarring. Another method, which I prefer, is to tighten the lower eyelid through the upper eyelid incision after completing the lower eyelid blepharoplasty. This avoids having to have the sutures taped to the forehead and helps to improve the position of the lower eyelids. I haven't had eyelid retraction when using this method, but both ways are effective. Just find a surgeon using the most up-to-date techniques, including transconjunctival blepharoplasty with fat repositioning. Avoid surgery involving dissection through the eyelid skin as this has a much higher risk of causing lower eyelid scarring and retraction.

Anyone hear of a lower eyelid lift with anchor to prevent the lid from sagging?

Answers (4)