PURPOSE:‎ ‎ This study aimed to report the outcomes of correcting severe congenital blepharoptosis by frontalis ‎suspension using combined silicone tube and 2–0 green braided polyester suture (Ethibond), and to compare ‎the results with those of silicone rod alone and Ethibond suture alone. ‎ PATIENTS AND METHODS: ‎ The medical records of patients below 16 years who underwent frontalis suspension were retrospectively ‎reviewed. Three groups of patients were identified; group I (16 patients: 22 eyelids) had frontalis ‎suspension surgery using silicone suspension set, group II (18 patients: 25 eyelids) underwent the surgery ‎using Ethibond suture, and group III (15 patients: 23 eyelids) was operated on using combined silicone and ‎Ethibond suture. The primary outcome measures were postoperative marginal reflex distance-1 (MRD-1) ‎and postoperative symmetry, and the secondary outcome measures were the occurrence of complications; ‎mainly recurrence and wound-related complications. The follow-up data were collected after 1 week, 1 ‎month, 6 months, 12 months and every 6 months thereafter. ‎ RESULTS: ‎ The follow-up period ranged from 18 to 36 months. By the last follow-up visit, 13 eyelids in silicone group ‎‎(59%), 11 eyelids in the Ethibond group (44%), and 13 eyelids in the double sling group (57%) achieved ‎good surgical correction with MRD1 ≥3mm; these differences were not statistically significant. The ‎difference in symmetry among the three groups was not significant. The highest rates of recurrence (44%) ‎and wound-related problems (8%) were encountered in the Ethibond group, while the silicone group had no ‎cases of wound-related problems. The lowest recurrence rate (26.1%) was in the double sling group but ‎those differences were not significant. ‎ CONCLUSION:‎ ‎ Combined use of silicone and Ethibond suture in frontalis suspension surgery could offer lower recurrence ‎rate and good final surgical outcome when compared to silicone rod or Ethibond suture alone.‎