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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Asymmetry & hanging columella. Interests: Tim Woolford, Julian De Silva, Julian Rowe Jones, Lucian Ion
I am 7 yrs post primary rhinoplasty. I was looking for my slight bump amd bulbous tip to be addressed. Immediately after my cast was removed 1 wk after my op, it was clear I had been left with an asymmetrical and hanging collumella (my natural nose did not have this). Its been 7 yrs & I'd like revision. My main concern is my hanging & aysemetric collumella, I feel my tip is bulbous in comparison to my thin bridge with large projection. I have very thick, oily skin with large pores on my nose.
(Questioner submitted photos)
Dr. Denenberg's answer: It's more than just the columella
It's not just that the columella is hanging, because your columella protrudes downward only a millimeter or two down beyond your nostril edges.
It's that the entire tip of your nose is low, the nose is very long, and best would be to raise the tip, much more than just elevating the columella.
You are correct that the tip is somewhat wide, too.
See the first patient in the attached video -- she has a nose with some similarities to yours.
Link to this question on RealSelf.com