AIM: The use of upper eyelid lipofilling to prevent ocular complications in patients affected by facial nerve palsy is compared to other treatment options. CASE PRESENTATION: Ten patients treated with lipofilling of the upper eyelid, who were indicated for facial rehabilitation were identified from the Maxillo-facial Surgery Unit, Policlinico Umberto I. For all patients, fat harvested from the abdomen was processed with soft and short centrifugation. RESULTS: Satisfactory aesthetical and functional results were obtained in most cases. All patients reported a considerable reduction in the use of artificial tear drops and ointment for corneal lubrication. A second procedure was needed in one case to refill the eyelid, and in another one to correct poor aesthetical results. No patients developed postoperative ocular surface disorders. CONCLUSIONS: The lipofilling of the upper eyelid procedure was easy to perform, leading to minimal complications rate. Given the small sample size and variability of samples collected in the current study, future studies involving larger cohorts are required to validate the efficacy of upper eyelid lipofilling in comparison to other treatments.