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Steven M. Denenberg, M.D.
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The paired jowls interfere with the contour of the jaw line as it moves from the chin up to the ears.  In the after picture, that contour is more triangular; in the before, the jowls make burbles in the smooth line of the jaw.  Note that her melolabial folds did not improve with the face lift, as they typically do not.

Her lower eyelids sit in a low position as a complication of lower eyelid surgery that was performed elsewhere.  The eyelid surgery tutorial's chapter on lower eyelid surgery contains a discussion on what can happen to the eyelids when the eyelid operation isn't performed with judgment and care.


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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: From a ridiculous extreme long/upward nose, to the other extreme ridiculous long/downward/wide nose
My 3d nose revision...devastated! (At same time: face, neck & lip lifts, fine!). See pre/post op photos plus 2 nose models I gave to surgeon as guidance. But nose is now much longer, wider, downward...Will it look like the nose models after swelling is gone? Doubt it. Wait a year to fix it? No! I’m desperate...Is there somewhere a competent surgeon who can do a shorter nose like my nose models? (I’m 87 but absolutely healthy). Thanks ever so much for your opinions!
(Questioner submitted photos)

Dr. Denenberg's answer: Your nose won't shorten as the swelling subsides
Hi,
Sorry, but it's just vanishingly unlikely that your nose will shorten as the swelling subsides, and certainly it won't shorten to the length of the models' photographs that you submitted.

The good news is that, with correct techniques, it is possible to shorten a nose substantially, even in a revision procedure. The bad news is that you can't jump in and have that operation right away. It may not be necessary to wait an entire year, but the nose needs at least many months to heal first.

Link to this question on RealSelf.com