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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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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: Best Options for a Small Nose Hump?
I just turned 14 and I have a bump on my nose, it is small but it is still a bump. The profile bothers me. I never had it before, and I do not have a big nose, it doesn't stick out, and from the front it is very small and narrow and slightly upturned at the end. My parents said that I can have a nose job if I really want one, but I am too horrified of doctors and blood and I have never had surgery. Will an injection nose job work? Will it go away as I grow older? What should I do?
(Questioner submitted photos)

Dr. Denenberg's answer: If your nose really bothers you, don't fear the surgery, but research your doctor well
Hi. From this one small photo, you have excellent facial features, and that hump on your nose. See my "Web reference" link for a morph I made to your profile, showing your nose without the hump. Your nose is attractively short, by which I mean that the tip is pointing up a little bit. You have a nice strong chin, so you don't need to have your nose brought back closer to your face. I can't tell about the width of the tip, but the hump is the only issue I see on this view.

Do NOT have an injection to your nose. Injections make the nose bigger, not smaller, they will not remove the hump, and they will make real surgery later more difficult and less predictable.

A woman is ready for a rhinoplasty when she is having regular periods and is about done getting taller. Late 14's and 15 is almost always fine. When you stop getting taller, the bump will stop growing!

The experience should not be at all bad. You would feel no pain during the procedure. I give my patients prescription pain pills to take afterwards, but almost nobody takes them because they don't need them.

One thing they don't teach you in ninth grade is that a doctor's board certification gives you no evidence at all of his skill in performing a rhinoplasty, and there are lots of plastic surgeons who cannot do the operation well. You protect yourself by seeing (lots of) before and after photos of the doctor's other patients. Seeing that a doctor has been able, many times, to accomplish for someone else what you want for yourself is the only way you can check out a doctor's skill in this area.

Link to this question on RealSelf.com