Alex Neusner, MD

Hi Kristin- this is a great question! you have something called "pseudoptosis". This is where the lower part of your breast sags but the nipple remains in good position. The best management depends on your goals. A lift alone would help with the sagging breast but would result in a rather small breast. In my opinion, adding a modest sized implant would greatly enhance your result and give you more upper pole fullness. Adding an "internal bra" generally refers to placing an absorbable mesh to support the soft tissue. In my opinion (and this varies greatly amongst surgeons), this is most beneficial if your select a rather large implant (over 350cc) and/or have a goal cup size of D or larger. Because you do not require a particularly large lift, I think that it would be completely reasonable to omit the internal bra.
Best wishes for your plastic surgery journey!
Alex Neusner, MD
Beverly Hills, CA

Hi, this is a great question. This depends on the reason for removing the implants. If you have breast implant illness or capsular contracture, the capsule should be removed. Otherwise, I would suggest leaving the capsule in place as this is a much less painful operation with lower risk of bleeding. You are absolutely correct that there is a risk of forming a fluid collection (known as a seroma) in the pocket if it does not re-adhere to the chest wall. For this reason, I typically will score the capsule to irritate the tissue and encourage it to heal.
Best of luck!
Alex Neusner, MD
Beverly Hills, CA

Hi! Great question as this body type is incredibly common! In my opinion, a full abdominoplasty (tummy tuck) is the best solution. Although you do not have a significant skin excess, the C-section scar is tethering your lower abdomen giving a "pooch" that will not get better with liposuction alone. Also, you likely have some rectus diastasis which is when your "6 pack" muscles spread apart in the midline, giving you a wider, boxy shaped abdomen. This requires surgical repair to correct. Finally, a tummy tuck will remove the small amount of excess skin, giving you a slim, fit figure. I very rarely recommend a mini-abdominoplasty and reserve this for cases where the lower abdomen or c-section scar is the only issue to be treated.
-In good health
Alex Neusner, MD
Beverly Hills, CA

Hi! A properly performed septoplasty should not alter the tip shape. However, there are always exceptions. If inadequate cartilage is left in place (the "L strut") there can be some drooping of the bridge and tip. Also, in the unlikely event that an open approach is used with a transcolumellar incision, there could potentially be scarring that pulls the tip down. Generally grafts are not used in a simple septoplasty unless a simultaneous rhinoplasty is being performed. Some surgeons place a prophylactic columellar graft (in the bridge that separates the nostrils) if an open approach is used.
Hope this helps!
Alex Neusner, MD
Los Angeles, CA

Hi there, as usual, there are no absolutes on anything. I would estimate that the vast majority of surgeons (myself included) recommend some sort of compression garment after a tummy tuck, particularly if there was a significant amount of liposuction performed. This will help prevent fluid build up under the abdominal skin flap (the part that was raised and "tucked") and helps prevent swelling in the areas with liposuction to help maintain a nice contour. However, you are correct that excessive compression will compromise blood flow to the surgical site which could cause wound break down. In my opinion, gentle to moderate compression is preferable after this surgery, however you would likely be fine without a compression garment and too loose is definitely better than too tight!

-Alex Neusner, MD
Los Angeles, CA