Abstract: An implant system includes an implant having a body having a proximal end, a distal end, a central cavity disposed between the proximal and distal end, and a proximal end opening disposed proximal to the central cavity. A toggle is at least partially housed within the central cavity and connected to the body by a toggle hinge connection, the toggle having a toggle lumen extending therethrough. An inserter includes an inserter lumen, and an actuator having a distal actuator tip configured to advance into the proximal end opening. An implant system, kit, method for placing an implant device, devices and systems using a pivot suture, suture loading device and related surgical procedures are also disclosed.