This woman had a face lift operation and a chemical peel of the skin around
her mouth. But she also had another procedure, called a pre-jowl
implant. The jowl makes a bulge in the jaw line, and there usually
appears to be a dent just in front of the jowl. The face lift pulls
the jowl's excess skin up and back toward the ear to smooth the jaw line, but
the smoothing can be more effective if we put something underneath the skin to
push out that dent at the same time.
That something is called a pre-jowl implant, and as the name suggests, it
fills out the depression in front of the jowl. The implant looks very much
like a chin implant, but it is shaped so that it doesn't make the chin stronger
from the profile view. The face lift surgery tutorial contains a chapter
devoted to the topic of pre-jowl implants (the surgery tutorials contain explicit photographs taken during surgery).
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I am considering a revision rhinoplasty. I am not sure if it is even an option for me.
First surgery in 1988. Closed procedure. Left me looking deformed, cartilage collapsed. Second surgery, different surgeon tried to repair with closed procedure. Nothing changed. He agreed needed to be a bit more aggressive. Did a third surgery with some grafting. Open procedure. Made changes, but I still feel as though I look deformed. This was all done in 1992-1993. Now I am 48. (notice assymetry, bulbous tip, and dent in the middle.) Want to find out if ever possible to fix.
(Questioner submitted photos)
Dr. Denenberg's answer: Meaningful improvement is likely in expert hands
From the information available in the photos, it does seem as though you should be able to get more improvement in your nose. What I notice: the upper part of your nose, where it's made of bone, is still a little wide, making an irregularity on the frontal view; the tip is still wider than it needs to be; from the front, the tip seems to droop down between your nostrils more than average; from the profile, the tip can still be elevated a little.
These are all changes that should be possible, even in a multiple revision. The problems relate to the size and position of bone and cartilage, and changing those elements of the nasal anatomy is very possible in revision surgery.
Link to this question on RealSelf.com