Objective: For patients suffering from facial palsy lagophthalmus is often a more serious problem than the inability to smile. The vulnerability of the cornea and the continous need of artificial tears or ointment lead to a restricted quality of everyday live. Reconstruction of eye closure by muscle transposition and free functioning muscle transplantation, respectively offers a good solution to regain near normal eye protection without the need of implants. Methods: In the last three years 44 patients have been treated for facial palsy including reconstruction of eye closure using eighter a temporal muscle transfer in 16 cases and a regionally differentiated part of a free gracilis muscle transplant in 10 cases, respectively. The patients were documented by a 3-D video analysis system. The mean age was 46.4 ± 17.5 years. Results: In the 12 patients with temporalis muscle transfer for eye closure, the distance upper and lower lid point could be reduced from preoperatively 10,2 ± 2,4 mm to 4,1 ± 0,5 mm postoperatively on the paralyzed side, compared to 0,0 ± 0,0 mm preoperatively and 0,0 ± 0,0mm postoperatively on the non-paralyzed side during closing the eyes like for sleep. In the (territorially differentiated) muscle transplant group, mainly consisting of congenital facial palses, eye lid closure could be improved from a löagophthalmus of 6,6 ± 1,5 mm preoperatively to 0,7 ± 0,4 mm postoperatively. In three cases the resting tonus of the part of the gracilis muscle transplant around the eye increased such a lot that muscle weakening by direct excision became necessary in the upper lid. Conclusions: Temporalis muscle transposition as well as using a free functional gracilis muscle transplant for reanimation of the eye and the mouth at the same time are reliable methods to reconstruct eye closure with clinically adaequate results. The temporalis muscle transposition garanties an innervation completely independent of the facial nerve system. Therefore synkinesia will not be developed. This seems more important than the possibility of emotional coupling which can be achieved by reinnervating a part of the gracilis muscle transplant by an additional cross-face nerve graft. Therefore temporalis transposition is the first choice method in adult patients. In children we prefer to use the free muscle transplant for eye closure, because we do not want to interfer with the growth of the face by transpositioning a local muscle, and because we believe in a higher degree of central plasticity in children.