This pleasant 70 year-old male presented with a chief complaint of visual field loss and an aged appearance of his upper and lower eyelids. He is extraordinarily active for his age, regularly participating in mountaineering, and kayaking along with other outdoor activities. This gentleman's ability to see well is critical. On physical examination he has significant brow ptosis (drooping) as well as dermatochalasis (excessive eyelid skin). I do not believe that an upper eyelid blepharoplasty alone would have achieved the functional improvement necessary to correct his visual field loss sufficiently and therefore a brow lift in addition to an upper eyelid blepharoplasty was performed to correct his condition approriately as well as satisfy his aesthetic expectations.