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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: 7 weeks post surgery, nose still looks worse/the same. Should I consider revision?
I have read from many doctors on real self by 6-8 weeks 80% of swelling after rhinoplasty should have gone. I'm 7 weeks post op and nose looks slightly worse than before op. I had the procedure as my nose was wide and pointed before. When I smiled my nostrils flared out and upwards, the tip pointed dropped down pointed into my teeth, as well as the whole thing looking wider. Nothing has changed post op. Should I consider revision?
(Questioner submitted photos)

Dr. Denenberg's answer: Your nose still looks long to me
These photos don't show your entire face, and there are no *true* profiles, but it seems that one of the main changes you nose required was to shorten it, raising the tip upwards.

Unfortunately, the tip doesn't tend to elevate with time. I would much rather that my patients are nervous because the tip is too high at seven weeks, than they be nervous because the tip is too low.

To get a substantial elevation of the tip, you will probably need a revision rhinoplasty. Elevating the tip, even during a revision, is quite predictable, if the doctor is expert at making those changes during a revision, so you must see a doctor's before and after photos before you have the operation. See the attached video and Web reference link for examples of what can be done in the right hands.

Link to this question on RealSelf.com



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