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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
brow lift
 
Views of this brow lift patient:

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Note how the crows feet area improved with elevation of the brow, and also note that, in the before picture, the tips of her upper eyelashes almost touch the bottom of her eyebrows.

The skin of the upper eyelid, just above the eyelashes, is very thin.  There is a thicker band of skin just underneath the eyebrows.  In the after picture, we can now see that band of thicker skin underneath the brows, because it has been pulled back up into a more normal position.


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current: Left oblique
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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: Does my New Nose Fit my Face?
I had rhinoplasty 4 years ago, but I've never been completely thrilled with my results. I told my surgeon at my 1 year that I was concerned too much was taken off the bridge, and the tip looked a little bulbous. He said I was over analyzing it and kind of got frustrated with me when i was upset my nose was dipped when we discussed keeping it straight. Here are my questions: is my tip bolbous, or does it fit my face? Is my nose still long? Does the profile view fit my face and look good dipped?
(Questioner submitted photos)

Dr. Denenberg's answer: You are correct about your nose, but the issue is the tip, not the bridge!
Hi,

You absolutely are not over analyzing your nose; there are some real issues, and your doctor should be able to recognize them. Click on the "Web reference" link in my answer for a morph showing a correction of the main part of your issues.

The problem is not that your bridge was over-resected; I don't think it was. The problem is that the tip of your nose is still over-projecting. That is, it projects too far forward, away from your face. Also, when a bridge is carved, and then when the tip's projection is lessened by bringing it closer to the face, the tip should be elevated. That is, raised, to make the nose look shorter.  "Shorter" means that the distance from where the nose begins between the eyes, down the length of the bridge to the tip, is less. As you'll see in the morph, when the tip is brought back closer to the face, the bridge no longer looks over-resected!

The problems that you have are not unusual, because deprojecting and raising a tip involve complicated work on the tip cartilages. An over-projecting and drooping tip are two of the most common issues I see in patients who are considering revision surgery.

The good news for you is that, in competent hands, bringing the tip of the nose back toward the face, and elevating the tip, are two of the most predictable changes that are made in rhinoplasty, even in the much-more-difficult revision rhinoplasty. Also, the techniques that elevate and deproject the tip often also work to narrow the tip.

As revisions go, I would be optimistic for a good result for you.

Link to this question on RealSelf.com



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