About the Procedure
Upper eyelid weight surgery is a procedure used in facial paralysis when the upper eyelid cannot close fully because the muscle that closes the eye is weak. A thin, custom-sized weight made of gold or platinum is placed in the upper eyelid, and gravity helps the eyelid close when the patient relaxes the lid.
The purpose is protective. When the eye cannot close, the surface can become dry, irritated, and at risk of injury. Restoring closure helps keep the eye lubricated and shielded.
At Norelle Health, upper eyelid weight surgery is considered as part of an individualized facial paralysis plan focused on eye protection. It is often combined with other measures for the eye and may be temporary or long-term depending on whether facial nerve recovery is expected.
Who may be a candidate
This procedure may be considered when facial paralysis causes:
- Incomplete closure of the upper eyelid (lagophthalmos)
- Eye dryness, irritation, redness, or a gritty sensation from exposure
- Difficulty protecting the eye, especially during sleep
- Risk to the eye surface that is not controlled by drops and ointments alone
An eye examination helps confirm that the eye surface is healthy enough and that a weight is the right step.
Considering upper eyelid weight surgery? The next step is a quiet, unhurried conversation.
How it is performed
Before surgery, weights of different sizes are often taped to the eyelid to select the one that gives the best closure without overcorrecting. The chosen weight is then placed through a small incision in a natural eyelid crease and secured to the eyelid structure.
The incision is closed so that the weight is hidden in the crease. The procedure is frequently performed under local anesthesia.
Recovery and aftercare
Eyelid swelling and bruising are common for one to two weeks, and the lid may feel heavy initially. Eye lubrication is usually continued during healing.
Most people return to normal activity quickly. The surgeon and eye-care team check that the eyelid closes adequately, the eye is comfortable, and the weight is positioned well.
Risks and alternatives
Possible risks include visibility or shifting of the weight, partial extrusion, infection, residual incomplete closure, astigmatism, or the need to adjust or replace the weight. Platinum is thinner than gold for the same weight, which can be helpful in some patients.
Alternatives and complementary measures include lubricating drops and ointments, moisture chambers, taping, lower eyelid tightening, and other eyelid procedures. The plan depends on the eye and whether nerve recovery is expected.
Results and follow-up
The procedure is intended to improve eyelid closure and protect the eye surface. If facial nerve function returns, the weight can often be removed.
Follow-up with the surgeon and eye-care team monitors closure, comfort, and the health of the eye, and confirms whether the weight should stay, be adjusted, or be removed over time.
Clinical references
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Specialists who perform upper eyelid weight surgery
Dr. Rakhna Araslanova
MD, FRCSC, FACS
Fellowship-Trained Facial Plastic & Reconstructive Surgeon — Facial Paralysis and Reanimation
Dr. Rakhna Araslanova is a fellowship-trained facial plastic and reconstructive surgeon who leads facial paralysis and reanimation at Norelle Health, with additional expertise in craniofacial reconstruction and aesthetic facial plastic surgery.
- Facial paralysis rehabilitation and surgical reanimation
- Craniofacial reconstruction
- Aesthetic facial plastic surgery
- Rhinoplasty
Also caring for this area
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(212) 444-8006Frequently Asked Questions
In facial paralysis, the upper eyelid may not close fully. A small gold or platinum weight uses gravity to help the lid close, protecting the eye from dryness and exposure.
The weight is thin and placed within a natural eyelid crease, so it is usually inconspicuous. Platinum is thinner than gold for the same weight, which can reduce visibility.
It can be temporary or long-term. If facial nerve function recovers and the eyelid closes on its own, the weight can often be removed.
It helps the eyelid close but does not restore a normal active blink. It is intended to protect the eye, often alongside lubrication and other measures.
Different weights are typically taped to the eyelid before surgery to find the one that gives the best closure without overcorrecting, then that size is implanted.
Eyelid swelling and bruising are common for one to two weeks, and the lid may feel heavy at first. Most people return to normal activity quickly while continuing eye lubrication as advised.
If closure is incomplete or the weight shifts, it can be adjusted or replaced, and additional eyelid procedures may be considered.
Related Conditions
Related Procedures
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