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Updated: Aug 16, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
[Experiences with upper eyelid gold implantation in facial paralysis]
Background:
A lagophthalmus following facial nerve palsy is not only a cosmetic problem, but can also cause serious complications to the cornea, such as ulceration and perforation. A passive eyelid closure can be achieved by the implantation of a gold weight in the upper eyelid.
Methods:
Within five years we performed 21 implantations of gold weights in patients with facial nerve palsy.
Results:
In 19 patients (90%) good eyelid closure was achieved. In three patients the gold weight was removed for the following reasons: remission of paralysis, foreign body sensation, and wound infection.
Conclusions:
The insertion of an eyelid goldweight in the upper eyelid in patients with established facial palsy is an effective method of reducing the incidence of discomfort to the eye and corneal complications. The insertion is simple and performed under local anaesthesia, and is easily reversed or revised if necessary.

