Suture tensioning systems, methods, and devices include a suture device for extracting a suture thread from a patient and then determining a location to secure the suture knot based on a balanced tension measurement. The suture device has a needle pass mount with needle passes, and a slidable eyelet assembly positioned opposite the needle passes. The eyelet assembly includes gripping portions for moving the eyelet assembly relative to other components of the suture device. Accordingly, eyelets extending from the eyelet assembly move through the needle pass mounts and extend out the needle passes. With the suture thread secured in the extended eyelet, the eyelet assembly is retracted. The suture thread is attached to a tensioning bar and tension meter. The tension meter indicates if the suture tension is within a threshold range and comparable to the opposite side, and a precise tying location for the suture knot is determined.