Background: One of the most awful and serious disorders that can impact patients with facial palsy is lagophthalmos. It may result in multiple ocular complications like (conjunctivitis, keratitis, corneal ulceration, and vision loss). It can be treated by multiple procedures, including levator palpebrae superioris (LPS) muscle lengthening, which invented by Paul Tessier.

Aim of work: The purpose of this study was to evaluate and assess the benefits and results of treating paralytic lagophthalmos by extending the upper eyelid's (LPS) muscle via aponeurosis interposition.

Patients and Methods: This prospective study included 15 patients with paralytic lagophthalmos (10 male and 5 female) and various causes of facial paralysis. With a mean age of 46.9 ± 15.2, the age group varied from 25 to 80 years old. All of the patients had one eye's levator muscle lengthened by aponeurosis interposition, as Paul Tessier describes it.

Results: Post-operative palpebral occlusion was complete in 13 patients (86.7%) and incomplete in 2 patients (13.3%). Most of patients experienced significant improvement of their ophthalmological symptoms after surgery. In all cases, the presence of the superior palpebral fold after surgery was found to be positive (100%). The aesthetic benefit was found to be satisfactory in all patients as well.

Conclusion: Treatment of paralytic lagophthalmos can be accomplished with favorable results in terms of both function and aesthetics by lengthening the (L.P.S) muscle using aponeurosis interposition, which is a straightforward, dependable, and reproducible operation.