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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
chin augmentation
 
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Many of the books that talk about classic proportions of the face describe how strong the chin should be.  Here's the guideline most books mention: on the profile view, find the lowest point on the lower lip where you would place lipstick.  Draw a line vertically down from that point.  The chin should come forward to touch that line.

However, guidelines are just guidelines.  Put a ruler on your computer screen, and you'll see that, even in the after picture, her chin doesn't come forward to that theoretical line.  And we would not want to make her chin any stronger than it already is.  Often, the best surgical plan is to attempt a good improvement, and not strive for some generalized goal that might not work on everyone.


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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



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