The suspension (Frost) suture: experience and applications.
BACKGROUND
The Frost suture is a well-known surgical technique for providing upward tension on the lower lid to prevent or correct ectropion after surgical interventions in the periorbital area. Despite its relatively common use, comprehensive information on executing this technique is not readily available.


OBJECTIVE
To review eyelid anatomy, indications, and proper technique for performing the Frost suture, as well as potential complications.


METHODS
A review of the literature on Frost sutures was performed. Cadaveric dissection was performed to demonstrate placement of the Frost suture.


CONCLUSIONS
The Frost suture is a useful method to reduce the risk of ectropion after surgery near the lower eyelid. Downward pull on the lid can occur with normal wound contracture even if ectropion is not present with the initial repair, reinforcing the need for preventive measures. Potential complications of this technique include superficial skin erosion of the upper lid, corneal abrasion, and blockage of the field of vision while the suture is in place.
*Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York; †The Skin Surgery Center and Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina; ‡Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; §Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
Karen L
KL
Connolly
John G
JG
Albertini
Christopher J
CJ
Miller
David M
DM
Ozog
D005143:Eyelids / Q000601:surgery*; D006801:Humans; D013536:Suture Techniques