An unfortunate result of facial paralysis is the loss of the ability to close the upper eyelid. The inability to blink and close the eye puts the eye at greater risk for injury or infection due to the fact the eyelid keeps the eyeball lubricated and protected from foreign objects. Although many patients with facial paralysis will regain complete eye closure within 3 months, for those who do not, the surgical implantation of a platinum eyelid weight can improve blinking and eye closure, which serve to protect the surface of the eye from damage and to relieve symptoms of eye dryness.
Although platinum eyelid weights are constructed from a strong, heavy metal, they are lightweight and won’t interfere with the eye or eyelid. Generally, platinum eyelid weights weigh between 0.6 and 2.0 grams, or about the same weight as a jelly bean. During a consultation, the best size and weight for your unique case will be decided upon using a sizing kit where the weights are temporarily taped to the outside of the eyelid.
The platinum makeup makes this type of implant safe for use in MRI scans, which is important as patients with facial palsy may need to be able to have imaging done as their condition is monitored. It is also unusual for platinum to irritate a patient’s skin, making it a good choice for use on the delicate skin of the eyelid. There will be a slightly visible bump on the eyelid where the platinum weight is implanted. The goal is to place it in the contour of the upper eyelid where it will be as inconspicuous as possible.
Although platinum weight placement may be clinically beneficial for many patients, this procedure alone may be inadequate in some with facial paralysis. Lower eyelid procedures may also be necessary to optimize closure in some patients.
This procedure involves a 1.5 cm incision in the upper eyelid crease and cutting through the thin upper eyelid muscle in order to expose the area where the platinum weight is anchored directly with sutures. The incision is then closed with sutures that will dissolve over the course of 7-10 days.
The procedure is typically performed on an outpatient basis, meaning the patient can return home the very same day. The patient is usually able to close their eye immediately following implantation and the function improves with time. Some swelling and/or bruising of the treatment area is common after surgery, but will heal in the coming weeks.
Recovery after platinum eyelid weight placement is very straightforward the vast majority of the time. Bruising and swelling in the upper and lower eyelid is normal for about 7-14 days after surgery. Most people are able to resume normal daily activities within 1-2 days after surgery, but should avoid strenuous activity (exercising, heavy lifting) for 2 weeks.