This patient had a severe right-sided facial nerve palsy (weakening of her facial nerve) leaving her unable to close her lids when she tried to blink. Her right eye was very irritated and needed to be addressed. She underwent a complex surgery which included placing a gold weight in her upper lid to help her close her lid better. In order to help elevate her lower lid, she also underwent a midface (SOOF lift) and lid resuspension, hard palate posterior spacer graft, and canthoplasty. I prefer to use a hard palate graft in cases of moderate to severe retraction; I find that they provide exceptional long-lasting results in lower lid retraction. She did well post operatively and was symptom free and her eye continued to be healthy.
Preoperative Diagnosis: Right upper and lower lid retraction from facial nerve palsy and difficulty closing right eye.
Procedure performed: Placement of gold weight in right upper eyelid, lower lid resuspension using canthoplasty and hard palate tissue graft to lower lid, and midface resuspension (SOOF lift).
This patient suffered a very severe facial nerve palsy where her whole left side of her face was paralyzed. She could not close her lids well and lower lower lid was retraction. She underwent a midface lift and lid resuspension to help elevate her lid to help her close her eyelids more appropriately. A posterior spacer graft was also used in the lid retraction repair. After the surgery, she was able to close her lids better and her symptoms had all resolved.
Preoperative Diagnosis: Left lower lid retraction from facial nerve palsy and difficulty closing left eye.
Procedure performed: Left lower lid reconstruction using canthoplasty and tissue graft to lower lid as a posterior spacer.