{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:24:30Z","timestamp":1787959470649,"version":"build-2784847793"},"reference-count":51,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Incomplete eyelid closure and lagophthalmos due to facial nerve palsy are significant functional and aesthetic concerns often requiring surgical correction. The aim of this systematic review is to quantitatively assess the efficacy, safety, and patient satisfaction associated with gold or platinum weight implantation, autologous fat grafting (lipofilling), and m\u00fcllerectomy. Methods: A systematic review was performed following PRISMA guidelines, searching PubMed, Embase, Cochrane Library, Web of Science, and Scopus up to March 2025. Studies included clinical data on surgical correction for incomplete eyelid closure in facial palsy, reporting functional, anatomical, and satisfaction outcomes. Quality was assessed using the Newcastle\u2013Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: Twenty-six studies including a total of 1205 patients were included. Gold\/platinum weight implantation achieved complete or near-complete eyelid closure in 83\u201392% of cases, with a reduction in lagophthalmos to &lt;1 mm. Complication rates ranged from 5\u201315% (mainly extrusion\/migration), and patient satisfaction averaged 7.9\/10. Lipofilling showed persistent benefit in 77% of cases, with 9\u201320% requiring repeat procedures and 10\u201312% experiencing minor complications. M\u00fcllerectomy yielded symptomatic improvement or resolution in 92% of cases, with a mean lagophthalmos reduction of 1.18 mm. Conclusions: Gold or platinum weight implantation provides the most reliable improvement for severe upper eyelid dysfunction in facial palsy. Lipofilling is a viable autologous alternative, while m\u00fcllerectomy is effective in selected cases. Further prospective comparative trials are needed to refine surgical selection and optimize outcomes.<\/jats:p>","DOI":"10.3390\/jcm14134688","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:35:52Z","timestamp":1751517352000},"page":"4688","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Upper Eyelid Static Surgical Approaches for the Treatment of Facial Palsy-Induced Lagophthalmos: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9213-2834","authenticated-orcid":false,"given":"Giovanni","family":"Ottonelli","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Humanitas University, Pieve Emanuele, 20090 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9049-2203","authenticated-orcid":false,"given":"Jacopo","family":"Celada Ballanti","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Humanitas University, Pieve Emanuele, 20090 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8714-4052","authenticated-orcid":false,"given":"Alessandro","family":"Gaeta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties (DIMI), Universit\u00e0 di Genova, Viale Benedetto XV, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8734-0186","authenticated-orcid":false,"given":"Gianmaria","family":"Barone","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Humanitas University, Pieve Emanuele, 20090 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Novella","family":"Montericcio","sequence":"additional","affiliation":[{"name":"Biomedicine, Neuroscience and Advance Diagnostic (BIND) Department, University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4889-6315","authenticated-orcid":false,"given":"Alessandra","family":"Di Maria","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/00002341-198801130-00004","article-title":"The surgical relations of the levator palpebrae superioris muscle","volume":"4","author":"Lemke","year":"1988","journal-title":"Ophthalmic Plast. 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