After facial palsy, there is incomplete eyelid closure, dry eyes, corneal exposure ulcers, and loss of Bell’s reflex due to loss of orbicularis oculi muscle function. The goal of upper lid reconstruction surgery is to preserve the cornea and keep it moist. The following describes the commonly used upper eyelid reconstruction surgical procedures. 1. Upper eyelid gravitational implant. A finished gold or platinum implant is placed in the upper lid to increase gravity to promote closure. The implants range in size from 0.8 to 1.8 g. They should not be placed too far up, as they may shift during sleep and cause incomplete eyelid closure. 2. Lid margin sutures, which can be either temporary or permanent, reduce the size of the lid fissure by fusing the lateral lid margins together, making closure easier. The lid margin suture is very effective but cosmetically less effective, making it difficult to meet the needs of children with very demanding families. 3. Temporalis muscle transfer. The surgery is performed by transferring strips of temporalis muscle + fascia or fascia lengthening followed by sutures at the upper and lower eyelids to assist in closure. This procedure relies on a branch of the trigeminal nerve (deep temporal nerve) to drive the muscle contraction and this procedure does not redirect the transient reflex. 4. Direct neuralization of the rotundus muscle. The nerve impulses of the temporal branch of the healthy lateral nerve are directly encapsulated in the orbicularis oculi muscle on the side of facial palsy through a trans-facial nerve graft. This procedure is less efficient and has unpredictable results. 5. Free muscle graft. Vascularized muscles such as the latissimus dorsi with a transfacial nerve graft technique can reconstruct eyelid function if successful. 6, Upper levator muscle toxin A injection. After injection, the levator muscle is paralyzed and the eyelid gradually closes. In summary: There are many ways to perform upper eyelid reconstruction surgery, and I personally would not actively choose a complex procedure; generally speaking the more complex the surgery, the more unpredictable the results. In my experience, most patients can achieve a satisfactory outcome with a combination of cosmetic and functional outcomes with an upper eyelid gravitational implant + lower eyelid external jairus cartilage stripplasty (see article on lower eyelid reconstruction surgery).