Getting her smile back

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"Nothing you wear is more important than your smile." - Connie Stevens

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Brianna Eli's current school, Michigan State University, had something to say on the subject of smiling back in November, 2015.

"It really does take more muscles to frown, about 47 of them. And for smiling, we only use about 13," wrote Jodi Schulz of the MSU Extension that year.

But what if health circumstances suddenly dictated that you might not be able to smile in a normal manner for the rest of your life?

Or to accomplish facial actions and life tasks most all of us take for granted?

That's the reality Eli lived during a health scare around the age of 22, when she was pursuing her BSN (Bachelor of Science in Nursing) at NDSU.

"I noticed progressive hearing loss in my left ear," she says. "It was a scary experience; I was unsure how life was going to look moving forward in the future."

Now 26 and continuing her schooling for her DNP-FNP (Doctor of Nursing Practice/Family Nurse Practitioner) at MSU, Brianna, the daughter of Curt and Barbara Eli of Carrington, described the start of her symptoms.

"All throughout high school, I had bad headaches with dizziness, some balance issues, nausea, and vomiting," said the 2016 CHS graduate.

Over the intervening years, that side of her face began losing sensation, causing paralysis and leaving her in need of answers to her condition.

Doctors would give Eli the sobering news: A benign tumor was growing on the nerves in her ear, and would have to be removed via a craniotomy.

Even with the successful procedure, Eli was resigned to the fact that she would be largely deaf in her left ear for the rest of her life.

A nerve adjacent to the ear which "feeds" the facial muscles was also permanently damaged.

"All I knew for certain was that this situation was going to be something that was extremely difficult. Everything else was unknown," Eli said.

Who could she turn to?

As it turns out, the University of Minnesota Medical School's Division of Facial Plastic Surgery had an answer.

Assistant Professor and Facial Plastic and Reconstructive Surgeon Dr. Sofia Lyford-Pike took on Eli's case.

Dr. Lyford-Pike explained to Eli that she and her team would, in her words, "rewire her face."

"I didn't even know that was an option until meeting her," Eli recounted in an advertisement for the medical school.

A common misconception, according to Lyford-Pike, is that patients only seek facial surgeries for vanity purposes.

Lyford-Pike shoots that theory down, saying, "Our faces are how people see - and judge - us. They're how we see - and judge - ourselves. And with just one simple look, faces can do what a thousand words often can't."

She explains that a total of 12 nerves deliver signals from the brain to the face. The nerves are simply numbered from 1 to 12.

In Eli's situation, it was number seven that was affected by the paralysis.

Lyford-Pike said that specific nerve is responsible for actions such as raising an eyebrow, closing the eye, scrunching the nose, and, yes, smiling.

Eli went under the needle, literally, for a five-hour craniotomy procedure to connect existing nerve branches and restore sensation and movement to her face.

The surgery included attaching a branch of the nerve from a muscle Eli uses to chew.

"It's really a testament to how plastic the human body is," said Lyford-Pike.

With follow-up visits, Eli was able to work with the facial nerve rehab team at the U of M after the transfer began to heal.

"I worked on physical therapy every day to regain function," she says.

Now, she can smile again just by thinking about it.

She will get periodical Botox injections on the right side of her face, in order to "kind of even it out a little more," and also as she gets older.

Eli is forever indebted to Dr. Lyford-Pike and her team for helping her get functionality and a sense of normalcy back in her life.

"The medical team at U of M did more for me than I think I can put into words. Experiencing a situation like this one tends to put things into perspective, and through that, I was given something priceless," she says.

Eli is scheduled to graduate from Michigan State in May, 2025, and hopes that her experience can allow her to "pay it forward" to her future patients in need.

(Editor's Note: Select information used in this article was taken from an advertisement for the University of Minnesota Medical School highlighting Eli's story.)