Double rhomboid silicone rod frontalis suspension

The frontalis suspension operation has proven effective for patients with significant ptosis and poor levator function. In patients with poor eye protective mechanisms, silicone rods may be used since the material has enough tensile strength to raise the eyelids yet it is sufficiently elastic to allow closure via action of the orbicularis muscle. This article reports the technique and results of a modified operation that uses two silicone rods per upper eyelid and eliminates fixation sutures to tarsus inferiorly and frontalis muscle superiorly. The results obtained are discussed. This technique provides a better upper eyelid contour and is easily adjustable postoperatively.