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San Diego Cosmetic Plastic Surgery

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Latest Updates: Cases of the Week

Revision Breast Augmentation with Strattice

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This 30 year old patient from Fontana California was interested in breast augmentation revision.  She felt that her right breast implant was bottoming out. She didn’t like the shape, size or placement of her breast implants.

After discussion of goals with Dr. Pousti, she felt very comfortable proceeding with revisionary breast surgery.

Markings and measurements are performed prior to surgery and goals are discussed again in detail.

The acellular dermal matrix (also called Strattice) is used on the lower pole of her right breast to improve placement (bottoming out).

Immediately after Revision breast surgery with Mentor High Profile 600cc silicone gel breast implants. The improved symmetry and placement are seen immediately.

 

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Posted in AlloDerm, Bottoming Out, Breast Pocket Correction, Breast Revision Surgery, Capsulorrhaphy (Internal Bra)


Revision Breast Surgery

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This 41 year old homemaker from Riverside County (Winchester California) had breast augmentation surgery 12 years ago but now wanted breast revision surgery. She was very happy with Dr. Pousti’s expertise and so she discussed her goals with him.

After examination, it was determined that revisionary breast augmentation surgery with some pocket adjustments, capsulorrhaphy and a benelli breast lift would improve her situation.

She decided to proceed with surgery… markings and measurments were performed prior to surgery (above)

Above photo shows the patient after breast implant removal.

Immediately after breast augmentation revision with Mentor smooth round high profile 800cc implants and a very nice improvement in size, shape and placement of the breast implants on her chest wall.

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Posted in Breast Lift with Implants, Breast Revision Surgery, Capsulorrhaphy (Internal Bra)


Revision Breast Surgery

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This 55 year old patient was interested in revision breast surgery and was looking for the best plastic surgeon to help her achieve her goals. Breast augmentation revision experience is what she was looking for in a surgeon. She found Dr. Pousti and was very pleased with his expertise regarding revision breast surgery.

breast augmentation revision

She was not happy with the size, shape and position of her current breast implants. Her breast implants fell outwards towards her armpits and she could feel the breast implant on the lower part of the right breast.

revision breast surgery

After examination and discussion of goals, it was determined that breast augmentation revision with larger saline breast implants as well as internal bra (capsulorrhaphy) and the use of Strattice (also called acellular dermal matrix) would be needed to improve her breast shape, size and placement.

internal braMarkings and measurements are performed prior to surgery.  The “arrows” show the areas where the patient was wanting more fullness.  You can see the right breast implant falling off to the side as well as the thin skin on the lower pole of the right breast that will be addressed during the surgery.

breast implant removal

Acellular Dermal Matrix

Above photo shows the piece of Strattice used during her procedure.

Revision breast surgery

revision breast augmentation

Immediately after revision breast augmentation surgery, capsulorrhaphy (internal bra), use Acellular Dermal Matrix right lower breast.  Breast implants are moderate plus profile saline 650cc-780cc overfilled to 950cc bilaterally.

 

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Posted in AlloDerm, Breast Pocket Correction, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Overfilled Saline Breast Implants


Revision Breast Augmentation with Internal Bra

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This 32 year old patient fromSan Diego California was referred by a friend to Dr. Pousti.  She was not happy with the size and/or placement of her breasts.  She was looking for breast augmentation revision surgery as well as the internal bra.

Revision Breast Surgery

After meeting and discussing her goals with Dr. Pousti, the patient felt very comfortable with Dr. Pousti’s expereince and decided to proceed with revision breast surgery.

Breast Augmentation Revision

internal bra

Markings and measurements are performed and goals are discussed.  The “red arrows” show where the patient is wanting more fullness.  The internal bra will be performed for better breast implant placement on her chest wall.

Breast Implants Removed

Above show the breast implants removed from the patient.Breast Implant Removal

The patient without breast implants – after breast implant removal.

Large Augmentation

XL breast implants

Immediately after revision breast surgery with ultra high profile, bilateral 750cc silicone implants placed.

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Posted in Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Implant Exchange


Male Abdominoplasty

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This 35 year old had lost a lot of weight and was left with loose, hanging skin.  He was interested in removing the excess skin and adipose tissue – male tummy tuck.

abdominoplasty

He searched for an experienced plastic surgeon to help him achieve his goals.  He found Dr. Pousti.

male tummy tuck

After examination, he felt very comfortable with Dr. Pousti’s expertise and proceeded to book his surgery.

tummy tuck

During the abdominoplasty surgery, the abdominal muscles are brought together (muscle plication seen above) and the excess skin is removed completely (seen in below photo).

Below shows the patient immediately after tummy tuck surgery.  The loose, excess skin has been removed. The recovery for the tummy tuck can take months as the incision heals and the swelling subsides. The incision line will flatten out and lighten in color as things heal.

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Posted in Abdominoplasty, Male Body Contouring, Procedures for Men


Bilteral Arm Lift

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This 59 year old patient from had been thinking about brachioplasty surgery for 5+ years.  She did not like the loose, hanging skin of her arms.  She researched for a plastic surgeon with expereince performing arm lifting surgery.  She found Dr. Pousti and was pleased with his expertise.

 

arm reduction surgery

After meeting and discussing options, the patient decided to proceed with booking her surgery date.  Dr. Pousti let her know that arm tissue relaxes with age, gravity and weight loss. The drooping of skin is from a stretching of the anchoring system of the arm and loss of supporting fat.

arm lifting

Brachioplasty (arm reduction surgery) can remove excess tissue and reduce the circumference of the upper arm. Surgical correction depends on the amount of extra skin and how loose the supporting tissues have become. Extra skin is removed from incisions along the inner arm. The incision must be placed where the tissue can be best tightened but the incision must be well hidden as well.

brachioplasty

During recovery, patients need to limit arm movement and/or heavy lifting to allow incisions to completely heal.

 

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Posted in Arm Lift


Removal of Breast Implants / Mastopexy Surgery

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This 33 year old had been thinking about removing breast implants for several years.  She was referred to Dr. Pousti by her family members and decided to come into the office for examinatin and discussion of options for her revision breast surgery.

revisionary breast surgery

After examination, it was determined that she would benefit from breast implant removal surgery as well as mastopexy surgery.  The patient understood that her final breast size without breast implants could not be predicted prior to surgery.. many factors involved in that determination.

breast augmentation revision

She felt very comfortable with Dr. Pousti’s experience and proceeded to the operating room for breast implant removal surgery and breast lifting.

revision breast surgery

Above photo shows the patient prior to the start of surgery.Dr.Pousti performs markings and measurements that serve as a roadmap for the surgery remove breast implants

Above photos show the “Tailor Tacking Technique” used to confirm that enough skin (but not too much) will be removed during the procedure.  Temporary staples are used along with the markings to visualize the final outcome prior to making an incision.

breast implant removal

Above photos show the right breast implant removed and breast lift performed.. nice comparison to the left breast (not yet operated on).

breast lifting surgery

mastopexy

Immediately after removal of breast implants and full mastopexy surgery.   The incisions can take up to 12-18 months to heal and fully mature.  As the incisions heal, they will flatten out and lighten in color.

 

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Posted in Breast Lift, Implant Removal


Revision Breast Augmentation with Overfilled Breast Implants and Internal Bra

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This 37  year old patient from Israel had been thinking about revision breast augmentation procedure for 2 years.  She was interested in the XL breast size. She wanted much larger, rounder implants with more fullness on top.

Revision Breast Augmentation

While researching online, she found that Dr. Pousti has expertise with revision breast surgery as well as the larger breast augmentation procedure.  She started an online consultation via email and decided to fly in to San Diego have her procedure preformed by Dr. Pousti.

XL breast augmentation

Markings and measurements are performed prior to surgery and the patients goals are discussed in more detail again.

breast revision surgery

Capsulorrhaphy surgery was also discussed with the patient for improved positioning of the breasts on her chest wall.  This is also called the internal bra procedure.  Dr. Pousti uses 2 layers of permanent sutures placed within the capsule that is around the breast implant to create a new pocket for the breast implant and therefore being able to improve positioning of the breast implants.

overfilled saline breast implants

Dr. Pousti uses the incision at the junction of the breast and areola for the best access to perform the internal bra.  Temporary sizers are placed to evaluate the size and position of the breasts during the procedure.

breast augmentatin revision

Below photo is of her silicone gel breast implants that were removed during surgery.

silicone gel breast implants

Large breast augmentation

XL breast augmentation

saline overfilled breast augmentation

Above photos show the patient after removal of her silicone gel breast implants and replacement with Mentor 800cc  over-filled Saline breast implants — 1500cc for both breasts.

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Posted in Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Overfilled Saline Breast Implants


Breast Augmentation / Mastopexy Surgery

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This 36 year old, mother of 6, had been thinking about breast augmentation / breast lifting procedure for years.

breast ptosis

She wanted her breasts larger, “lifted” and “more perky” .  She researched for the best plastic surgeon to help her with her breast augmentation surgery and found Dr. Pousti.  After examination, it was determined that breast implants as well as a full breast lift would be necessary to achieve her goals.

breast enhancement

Breast augmentation / mastopexy surgery and the potential risks and complications were discussed with the patient in detail and the patient was taken into the operating room.  The markings performed prior to surgery are used as a roadmap during the procedure.

mastopexy

Below photos show the “tailor tacking technique” in which temporary staples are used to confirm that the measurments and markings are accurate.  Dr. Pousti wants to remove enough skin to “lift” the breasts but needs to be careful not to remove too much during the procedure.

mastopexy

breast augmentation/ lifting

Above photo shows the patient immediately after breast augmentation / lifting surgery with Mentor high profile silicone gel breast implants – L 400cc R 375cc

breast surgery

Tapes are placed over the incisions for protection – these tapes need to stay clean and dry for 4-6 weeks as the incisions heal.

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Posted in Breast Lift with Implants


Removal of Bilateral Breast Implants, Ruptured Silicone Gel Breast Implants

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This 63 year old patient living in California, had breast augmenation surgery 33 years ago but was now experiencing some firmness of the left breast.  The capsular contracture was uncomfortable for her and so she decided to find the most experiences plastic surgeon to remove her bresat implants as well as the scar tissue around the left side.

Capsular Contracture

After searching online, she came across double board certified plastic surgeon, Dr. Tom Pousti and was very pleased with his experience with revision breast surgery and breast implant removal procedures.

Revision Breast Augmentation

In the operating room, Dr. Pousti found bilateral ruptured silicone gel breast implants (from 33  years ago) .. see below

Ruptured Silicone Gel Breast Implants

The ruptured breast implants as well as the scar tissue were removed and the cavity was cleaned out. Drains are placed for the first week after surgery and are removed when the output is low.

 

Breast Implant Removal

remove breast implants

breast augmentation revision

The patient is very pleased with her decision to remove her breast implants.

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Posted in Breast Revision Surgery, Capsular Contracture, Implant Removal, Ruptured Implants



Pousti Plastic Surgery Center
Pousti Plastic Surgery of San Diego
8851 Center Drive, Suite 300
La Mesa, California 91942
Phone: (619) 466-8851 or Email
 
Dr. Tom Pousti is a San Diego and La Jolla Plastic Surgery specialist. He has provided plastic surgery treatments to many San Diego and La Jolla facelift, tummy tuck, liposuction, breast augmentation, and rhinoplasty patients. His office is located in San Diego, and also serves the La Jolla, Riverside, Inland Empire and Temecula areas. Disclaimer


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