A gold weight implant is a small piece of gold or platinum inserted into the upper eyelid to help it close in patients with facial nerve palsy. The added weight allows gravity to assist lid closure when the frontalis and orbicularis muscles are weak.
Procedure
Through a crease incision, the surgeon creates a pocket in the upper lid and secures the weight to the tarsal plate or levator aponeurosis. The weight is selected based on pre‑operative testing to achieve closure without excessive droop.
- Performed under local anaesthetic with or without sedation
- Reversible and adjustable if lid height or cosmesis are unsatisfactory
- Often combined with lower lid tightening or brow procedures
- Platinum chains are an alternative with a slimmer profile
Outcomes and Risks
Gold weights can significantly improve blink completeness and reduce exposure keratopathy. Some patients notice mild upper lid heaviness or visible contour of the implant.
- Complications include implant migration, extrusion, or allergy, though these are uncommon
- Regular follow‑up monitors corneal health and lid position
- Later facial reanimation procedures may allow weight removal
- Ongoing lubrication is still recommended, especially at night
