Fig. 8. The caliper is used to check the placement of both ends and the middle of the muscle. If the middle of the muscle sags, one end of the suture is passed up through the center of the muscle, just behind where the preplaced suture passes through the muscle, near the distal end. This suture is tied to the other end of the suture to bring the sagging portion of the muscle up to the knot, thereby eliminating the sag (recession).