Patients with complete facial nerve palsy are at risk of severe eye complications due to corneal exposure. Gold weight implantation improves function, cosmetic appearance and morbidity. Three patients with nerve palsy underwent insertion of precisely prepared gold weights between May 2000 and December 2001. Individual gold weights were implanted into a small pocket between the orbicularis oculi and the tarsal plate of the upper eyelid, fitting the curvature of the eye. According to follow-up examinations (after at least 5 years), none of the gold weights had extruded; all patients experienced marked improvement of their dry-eye symptoms and expressed a high degree of satisfaction. Implantation of gold weights is effective and should be considered in all patients for the management of paralytic lagophthalmos.