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Steven M. Denenberg, M.D.
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face lift and chemical peel
 
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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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"When I look in the mirror,
I am in disbelief at how natural it looks ... "
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lift and peel
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face lift and chemical peel

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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: Do I need a revision rhinoplasty?
I like everything about my new nose but the tip. Im 20 months post op and I'm not thrilled about the tip. It's very round and sort of droopy. Especially in pictures. At my last follow up, my doctor acknowledged that the skin underneath the nose was a little loose but even with the new procedure, there's a chance it'll still look the same way it does now. He claims there's no way to get rid of the skin. Thoughts?
(Questioner submitted photos)

Dr. Denenberg's answer: It doesn't look like loose skin to me.
I have to say, I've never seen a case where drooping at the bottom of the nose there is loose skin hanging down. It's either cartilage or scar tissue.

This far after surgery, if the nose is still too big, you're looking at a revision. There are a couple of pieces of good news for you, though. It appears, from these photos, that the size is the result of strong cartilages under the skin, and a revision where reduction in size is the goal is more predictable than some other changes we try to make.

I would try to elevate the entire tip of your nose -- that's key -- narrow the tip, bring the whole nose back closer to the face, lower the bridge to match the new position of the tip.

Link to this question on RealSelf.com