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Steven M. Denenberg, M.D.
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Her jowling and excess skin in the front of the neck was advanced enough to warrant a face lift operation.  She also had a brow lifting procedure.  Gravity pulls on everything.  Everything.  And the brows don't escape.  It's natural for them to drop in position over time, although of course the amount they drop and at what age they drop mostly depends on heredity.

The brow lift can be an excellent adjunct to the face lift operation.


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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
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Questioner: I'm trying to understand my surgeon's operative report in order to understand what was and wasn't done. Please help?
As the photos demonstrate, my primary rhinoplasty was not successful in any way, shape, or form. Since acquiring my surgeon's operative report, I've been trying to make sense of the medical terminology in order to understand what was done to my nose during my operation... Thus educating myself. I want to fully understand as I navigate my revision consults. I keep telling people that the "tip wasn't touched at all," but aside from that, could someone please help me interpret the report? (Photos).
(Questioner submitted photos)

Dr. Denenberg's answer: It doesn't look as though much was done to your tip.
The report says "a portion of the lower lateral cartilages" was removed. That *can* result in a tip that is less wide, or less projecting, but it's the rare, rare tip that will respond completely to a simple removal of some of the tip cartilages as described. Perhaps your tip requires much more advanced work to change it's size and shape.

If you are seeking a revision, be very careful. Revision rhinoplasty is far, far more difficult than a first-time rhinoplasty, and even in a first-time rhinoplasty, most plastic surgeons are not expert enough to handle more difficult tip structures. You must see before and after photos of a doctor's work before deciding whether to use him for your revision. See the attached video and the Web reference link for examples of the changes that are possible in expert hands.

Link to this question on RealSelf.com