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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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face lift and chemical peel
lift and peel
current: Right oblique
face lift and chemical peel

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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
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Questioner: My nose looks like it's cut in the middle, and looks like an extension?
From the picture you can tell that the surgeon made a mess. Looking at the picture, do you think a surgery is necessary?
(Questioner submitted photos)

Dr. Denenberg's answer: No fillers, please! But I believe improvements can be made.
Hi,

I know it's just one photo that you posted, but there are generally ways to improve the areas that you complain about in a revision rhinoplasty. 

The "dents" can often be filled in with cartilage grafting, and they can be made further inconspicuous by lowering prominences of bone next to the dents.

Then, I don't know whether this bothers you, but the tip of your nose can be raised, too. Whenever a nose is a little smaller, the bothersome features often are less noticeable. I shortened your nose in my morph.

My guess is that the doctor who recommended fillers or fat grafting does not perform revision rhinoplasty. Respectfully, I just think that's not a good solution for what I see in your photo.

Link to this question on RealSelf.com