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    Brighter view thanks to eyelid lift

Ellen Teske isn't one to sit still for too long. In the winter, you can find her on the ski slopes with her siblings or with her feet in snowshoes. During the summer, she is in her flower garden, at the local farmers market, biking or on her paddleboard. And there was no slowing down for her in retirement either. The day after she retired from North High School, she hit the open road for a monthlong motorcycling adventure with her brother.

During her many adventures, she started to notice that her night vision wasn't quite what it used to be.

"When I was driving toward lighted cars, I would see rays of light. I just thought that was how it was for everyone," says the 65-year-old Eau Claire, Wisconsin, resident. "It seemed like my eyelashes were in the way."

Ellen decided to make an appointment with Marianne Komro, O.D., a Mayo Clinic Health System optometrist, and Ellen had an odd request.

"I asked her if I could cut my eyelashes so I could see better at night," says Ellen with a laugh. "She told me 'no' and recommended that I take a vision field test."

A person's visual field is the full extent of what can be seen to the sides without moving the eyes, explains Dr. Komro.

"A visual field test, also known as a perimetry, determines whether a person is having difficulty seeing in any areas of the overall field of vision," says Dr. Komro. "I was concerned that Ellen may have a vision field defect based on the concerns she shared, and the shape and position of her eyelids."

During the automated perimetry test, Ellen looked at a screen with blinking lights and was directed to press a button each time she saw them blink.

"It was the first test I have ever failed in my life," says Ellen. "I only saw 16 of 64 flashing lights."

Based on her results, Dr. Komro referred Ellen to Yvonne Pierpont, M.D., a plastic and reconstructive surgeon at Mayo Clinic Health System. During the consultation, Dr. Pierpont examined and measured Ellen's face, and recommended an upper lid blepharoplasty and brow lift for the best results to improve her field of vision.

An upper lid blepharoplasty, also known an eyelid lift, is the No. 1 plastic surgery procedure performed, explains Dr. Pierpont. It is a type of surgery that repairs droopy eyelids by removing excess skin, and sometimes muscle and fat.

"Over time, the skin of the eyes is the thinnest skin in the body and with time, it loses elasticity. This leaves excess and baggy skin that can interfere with your vision and make you look tired," says Dr. Pierpont.

Eyelid lifts can be combined with an eyebrow lift. During a brow lift, the surgeon uses different incisions to raise the soft tissue and skin of the forehead and brow.

"Often patients think that their eyelids are the only issue. They do not know that the skin below their brows is different than eyelids and also can be a contributing factor," says Dr. Pierpont. "About half of patients may benefit from the addition of a brow lift or eyelid muscle tightening in addition to the eyelid lift. And oftentimes, these are considered medically necessary to improve the visual field and therefore a covered insurance benefit."

At first, Ellen was concerned when she heard Dr. Pierpont's recommendations.

"I went into panic. My first thought was all the movie stars and how awful they look after plastic surgery," says Ellen. "I told Dr. Pierpont that I didn't want to come out looking like a 35-year-old. I want to look age-appropriate."

Dr. Pierpont assured Ellen that they had the same goals: to improve her field of vision while preserving her natural appearance.

Dr. Pierpont explained that the incision for the eyelid lift is hidden in the eyelid's natural crease and the brow lid incisions are hidden in her hairline so she would have little to no visual scars. In addition, Ellen's procedures could be covered by her insurance because of her documented visual field defects. And the procedure would be performed as a same-day surgery, which meant that she could recover comfortably at home.

After discussing these options with family, Ellen decided to move forward with the procedures. She says she felt calm on the day of her surgery, and Dr. Pierpont met with her prior to surgery to discuss the plan, and mark incision locations on her face and hairline.

"I looked a bit like Frankenstein, but she was very precise and marked around my hair follicles," Ellen recalls.

After surgery, Ellen was bruised but felt great. "Dr. Pierpont was very honest with me and said that it would like I got beat up," she says. "She was right, but it didn't actually hurt. I was pretty much pain-free."

Every day, Ellen's bruising improved. "I'm a bit nerdy with the science so it was interesting to see my bruises progress. I knew I was healing," she says. "I iced my eyelids and slept in my recliner for a few weeks but was amazed at how quickly I felt great again."

Ellen was able to return to her active life three weeks later and noticed significant improvements in her vision.

"Every morning, I take my dog for a 3-mile hike. Now I can see out of the side of my eye. I hadn't realized how much I was missing before," she says. "This is like surround sound of vision, and the world opened up for me."

Dr. Pierpont explains that Ellen's experience is common for patients who have had these surgical procedures.

"I often hear from patients how much brighter everything appears or how much more they can see especially above and to the sides," she says "This are gratifying procedures for patients and myself, as they notice significant improved in what they can see and how they look."

Others noticed, as well. "It seems that people notice you look different but can't pinpoint why. I went back to sub at the school and got comments like 'Retirement has done you well' and 'You look so well-rested,'" says Ellen. "When I texted a photo of myself all sweaty after a long hike to my siblings, their only comments were how great my eyes looked."

Overall, Ellen is very pleased with the results of her surgery and how it has affected her quality of her life.

"It's opened my eyes to a new world," she says. "I still look like me and it didn't change my overall look, but it made living so much better and brighter."

This story also appears on the Mayo Clinic Health System Hometown Health blog. You can find it there and share it with others https://www.mayoclinichealthsystem.org/hometown-health/patient-stories