Alex Neusner, MD

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

Hello,
These are great questions. It is true that maintaining a stable weight at a "normal" BMI does minimize the risk for wound complications and of course demands less aggressive tissue/fat removal. However I routinely perform abdominoplasty on patients with "high" BMI with generally outstanding results (even with BMI as high as 50!). I think that 5'9" 200lbs is a very reasonable weight to safely undergo tummy tuck and liposuction. I would recommend that you seek out a surgeon who is experienced in operating on similar patients and would not "force" a surgeon into operating if he/she is not interested.

With regards to drains, I feel that they are essential in nearly any tummy tuck, although I admit my colleagues have demonstrated some excellent outcomes without using them. Particularly in larger patients, I think the the use of drains to prevent fluid collection under the tissue flap is extremely important and well worth the inconvenience to assure proper healing.

Best wishes,
Alex Neusner MD
Los Angeles, CA

Hi,
The simple answer to your question is yes, a facelift/necklift would tighten and elevate your skin and would help reposition some early descent of your midface/buccal soft tissue to soften your nasolabial folds (folds between your cheek and nose/mouth). HOWEVER, you have relatively minimal skin excess, a beautifully defined jawline, and appear to have excellent skin quality. If you have not already, I would recommend exploring non surgical skin rejuvenation therapies such as Ulthera or Renuvion. While I am not universally impressed by these treatments, I think you are an excellent candidate for these. Regardless of what you pick, I think you will have a beautiful outcome.

Best wishes.
Alex Neusner MD
Los Angeles, CA

Hi, I think this is most likely a suture granuloma- your body decided to react to one of the sutures used and developed some chronic inflammation. Regardless of cause, at 2 years postop I would recommend excising the area and re-closing.