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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
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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All views of this lift and peel patient:
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.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: Why is my Tip Still Droopy After Rhinoplasty?
I had closed rhinoplasty. If my tip was lifted, why does it still look the same as before? I'm frustrated... It just seems like the distance between my tip and upper lip is a bit different, but the tip is droopy and shaped droopy-like just like before. Why? was it the technique?
(Questioner submitted photos)

Dr. Denenberg's answer: It's certainly possible that you nose simply wasn't shortened in the previous operation
Hi. The photos you sent are sort of tiny, but they do show the relationship between the bottom of your nose and your upper lip, and it appears that the nose is still long. See my "Web reference" link for a morph I made of your nose, showing what it might look like if it were shortened.

Shortening a nose, in expert hands, is one of the more predictable changes to make in a nose, even in a revision, but it requires some complicated work on the tip cartilages. Still, no operation is 100% successful. You have a decision to make about using your same surgeon for a revision. If you feel that you selected him well, and you saw lots of his before and after photos, proving that he has shortened long noses for other patients and does excellent work in general, then take his advice about a revision to try again to shorten your nose.

However, if you did not see lots of before and after photos, and you suspect that he might not have been able to shorten your nose in the first place, then you should not have him revise your nose, because he is unlikely to succeed, and it can get you into more trouble.

Link to this question on RealSelf.com



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