Adjustable suture technique for levator surgery

Externalized adjustable sutures allow for early postoperative adjustment of lid height and contour. The predictability of levator surgery both for ptosis repair and for recession for eyelid retraction may be influenced by several factors, including variable orbicularis muscle and Müller muscle response to local anesthetic injection; intraoperative hemorrhage involving orbicularis, Müller, or levator muscle; and variable patient cooperation when surgery performed under intravenous sedation. These factors may confound efforts to achieve the desired postoperative result, even when eyelid position and contour are satisfactory at the time of intraoperative adjustment. In certain cases, adjustable sutures may be a useful adjunct in eyelid surgery.