Gold and Platinum Eyelid Weight Surgery

Facial palsy can make it difficult or impossible to close your eye fully. This leaves the surface of the eye exposed, which can be painful and may cause serious damage over time. One of the most common surgical solutions is to place a tiny weight inside the upper eyelid, which uses gravity to help the eye close more completely.

This page focuses on eyelid weight surgery. There are other surgical options for improving eye closure — your surgeon can explain which approaches might be right for you.

Why does the eye need to close properly?

Every time you blink, a thin layer of tears is spread across the surface of your eye, keeping it moist and protected. When facial palsy weakens the muscles around the eye, blinking becomes incomplete or stops altogether. Without this protection, the eye’s surface can become dry, sore, and scratched.

Left untreated, this can lead to serious problems including scarring that permanently affects your vision. Eye drops and ointments can help in the short term, but they don’t fix the underlying problem of the eye not closing properly.

How does eyelid weight surgery work?

A small weight — roughly the size of a small fingernail — is placed inside the upper eyelid during a minor operation. It sits between the layers of the eyelid, close to the lash line. When you relax your eye or look downward, the weight uses gravity to pull the lid down over the eye.

The operation is usually done under local anaesthetic (you are awake but the area is completely numb) and takes around 30 to 60 minutes. You can go home the same day. The cut is made in the natural fold of your upper eyelid, so the scar is usually well hidden. The procedure is reversible so if your surgeon isn’t happy with the outcome it can be removed or swapped if needed. It is also adjustable and can be changed if your facial palsy improves over time.

Gold or platinum — what’s the difference?

Both gold and platinum implants have been used successfully for eyelid loading surgery. However, platinum is increasingly preferred because it is denser, less visible beneath the skin, and has a substantially lower reported risk of allergic reaction.

Platinum weight

• Denser than gold, so a smaller implant achieves the same effect
• Less visible through the eyelid skin
• Often provides a more natural appearance and contour of the eyelid
• Very rarely causes intolerance or allergic reactions
• Has been shown to be more cost-effective over the long term because fewer revision procedures are required

Gold weight

• Has been used for many decades and remains effective at improving eye closure
• Requires a larger implant than platinum to achieve the same weight
• May be more noticeable beneath thin eyelid skin
• Can occasionally cause an allergic (hypersensitivity) reaction, requiring removal and replacement of the implant

For these reasons, many surgeons now routinely use platinum implants as their first choice. Gold implants are used less commonly than in the past. Your surgeon will discuss which implant is most suitable for you and explain the reasons for their recommendation.

Finding the right weight

Before your operation, your surgeon will tape small trial weights to your closed eyelid to see how different sizes affect your eye closure. The aim is to find the lightest weight that allows the eye to close well, because a heavier weight, while better at closing the eye, is more likely to cause problems like blurred vision or a droopy-looking lid when your eye is open.

What to expect before, during, and after

Before your operation

You’ll have an assessment to check how well your eye closes and to find the right weight. Keep using your eye drops up to the morning of surgery. If you take blood-thinning medication, your team will advise whether you need to pause it.

During the operation

After numbing the eyelid with a local anaesthetic, the surgeon makes a small cut in the fold of your upper eyelid, creates a small space between the layers of the lid, and places the weight inside. The weight is fixed in place with fine stitches, and the skin is closed.

The first couple of weeks

Your eyelid will be swollen and bruised, this is completely normal and settles over 1–2 weeks. Continue using your eye drops or ointment. Most people feel comfortable returning to light activities within a few days and to work within 1–2 weeks.

Follow-up

You’ll have a check-up around 2–6 weeks after surgery. If the eye still isn’t closing enough, a heavier weight may be tried. If the eyelid looks too droopy when your eye is open, a lighter weight or small adjustment can be made.

What are the risks?

Eyelid weight surgery is a straightforward operation with a good safety record. But as with any procedure, there are some things that can go wrong.

• Eye still not closing fully — the weight may not be heavy enough. A second procedure with a heavier weight may be needed.
• Eyelid sitting too low — if the weight is too heavy, the lid may look droopy when your eye is open, affecting your field of vision. A lighter weight usually fixes this.
• Blurred or slightly distorted vision — a heavy weight can press gently on the eye and temporarily affect sharpness of vision. This usually improves if the weight is swapped for a lighter one.
• Visible ridge through the skin — in people with very thin eyelid skin, the edge of the weight may be faintly visible. Platinum chain weights are less likely to cause this.
• Weight working through the skin (extrusion) — very rarely, a weight can gradually push through the skin. It would need to be removed and replaced.
• Infection — any implant carries a small risk of infection. Signs to watch for include increasing pain, redness, or swelling beyond the first few days. Contact your surgical team promptly if this happens.
• Allergy or intolerance to the implant — this is uncommon but has been reported with gold implants. If a significant reaction occurs, the implant may need to be removed and replaced. Allergic reactions to platinum implants are exceptionally rare.
• Needing further surgery — weights may need adjusting over time, especially if your facial palsy improves and your natural blink starts to return.

What if my facial palsy gets better?

The weight can be removed if your facial palsy improves and your eye starts closing on its own again. Your eyelid will generally return to how it looked before the operation. Because recovery from facial palsy can sometimes happen slowly over months or years, your surgeon will usually want to keep monitoring you rather than removing the weight too soon.

Common questions

Will I be able to feel the weight?

Most people are not aware of the weight once the initial healing has settled. Some notice a slight heaviness when first opening their eyes in the morning, but this usually fades.

Can I have an MRI scan with the weight in place?

Gold and platinum are not magnetic, so eyelid weights are generally safe for MRI scans. Always let the MRI team know about your implant beforehand, as each hospital has its own checklist.

How long will the weight last?

There’s no set lifespan, the weight can stay in place as long as it’s working well and not causing problems. Some people do need a swap or adjustment at some point, but many have theirs for many years without any issues.

Can children have this surgery?

Yes, it can be done in children, but it needs careful planning because children’s eyelids are smaller and they may need a general anaesthetic. A specialist team experienced in treating children would be involved in this decision.

Will people be able to see the weight?

For most people, the weight is not noticeable. The scar sits in the natural fold of the eyelid and is usually well hidden. In a small number of people with very thin eyelid skin, there may be a slight fullness, in which case a platinum chain is usually the better choice.