Frontalis muscle suspension is the operative choice for the correction of severe ptosis when there is levator function less than 5 mm. Different materials are used for suspension. Autografts such as fascia lata, temporalis muscle fascia, palmaris longus tendon are used to avoid antibody responses and prion diseases. However, it adds up to the surgical trauma and time. Synthetic materials, such as mersilene mesh, non-absorbable suture materials, polytetrafluoroethylene strip and silicone rod, may cause foreign body reactions but avoid additional surgical time and trauma. Silicone rod is widely used, due to its flexibility. Self loaded silicone rods are also available. The mostly used configurations are double triangle, rhomboid and pentagon. The double rhomboid is preferred where autografts are used. Rhomboid and Pentagon configurations are preferred for allografts or xenografts in order to decrease the amount of foreign material. Surgery is done under anesthesia. Acrylic shields are placed to protect the cornea. The complications are undercorrection, overcorrection, irregular lid crease lagophthalmos, corneal erosions, entropion, granuloma formation, suspension material exposure.