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San Diego Cosmetic Plastic Surgery

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Latest Updates: Cases of the Week

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


Breast Lifting / Breast Asymmetry

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This 35 year old was unhappy with the size and shape of her breasts as well as her breast asymmetry.  She wanted to improve things and so she researched for the best plastic surgeon to help her with her breast surgery.

breast asymmetry

After meeting the patient, she and Dr. Pousti discussed that her procedure would be best performed in multiple stages. The first surgery would be mastopexy surgery to improve the shape of her breasts as well as improve the breast symmetry.  After things heal, we can proceed with breast augmentation surgery to achieve fuller breasts.

breast lifting

The patient agreed and proceeded to have surgery.  Because of the significant breast asymmetry, Dr. Pousti preformed an anchor breast lift on her right breast and an areolar breast lift on her left breast.

mastopexyAs you can see below, the results after her breast lifting surgery are very nice.  She has a nice shape to her breasts and the symmetry is much improved.  Now the patient is able to return to the operating room for placement of breast implants.

breast augmentation

breast implants

 

 

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Posted in 2 Stage Procedure, Breast Asymmetry, Breast Lift


Breast Implant Removal

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This 47 year old previous patient of Dr. Pousti had been thinking about removing her breast implants for a few years. Dr. Pousti performed her breast augmentation surgery 10+ years ago and she was very pleased with the outcome. She is now at a different point in her life and now wants her breast implants removed.

breast augmentation

After examination and discussion with Dr. Pousti, she proceeded with her breast revision surgery.

revision breast surgery

 

silicone gel breast implants

Above shows her intact, silicone gel breast implants that were removed.
breast implant removal

remove breast implants

Above photos show immediately after breast implant removal. It may take a few months to see the final results and the skin “bounce back”.

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Posted in Implant Removal


Revision Breast Surgery, Breast Asymmetry, Encapsulation, Breast Implant Removal

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This 44 year old from El Cajon, California was referred to Dr. Pousti for breast augmentation revision by a good friend.  She had previously had berast surgery and was not pleased with her results.  She had significant breast asymmetry, encapsulation as well as enlarged areola.  She was not happy with the size, shape or placement of her breasts.

breast asymmetry

After meeting with Dr. Pousti, she knew he was the best plastic surgeon to help her with her revisionary breast augmentation surgery.  They discussed performing a revisionary breast lift procedure along with removal of breast implants followed by a 2nd stage breast augmentation surgery after things had healed.

breast revision surgery

The patient understood the complexity of her case and agreed to doing things in stages.  She decided to proceed with the breast implant removal and mastopexy surgery.

revision breast surgery

Markings and measurements are performed prior to surgery (above) and the procedure is discussed in detail with the patient again.

tailor tacking technique

Above photo shows the left breast with tailor tacking….. Tailor tacking  is an important part of the mastopexy and mastopexy/augmentation procedure. It involves TEMPORARY  closure of the skin (for example with temporary skin staples)  to double check the amount of skin that is to be excised during the procedure. This maneuver is done to ensure that enough skin, but not too much, is removed. On the one hand, it is important that enough skin be removed to achieve the aesthetic breast lifting results the patient is looking for; on the other hand, is important not to move too much skin creating tension upon closure and potential wide scars.

breast implant removal

Above photo shows the capsules and breast implants that were removed

mastopexy

breast lift

 

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Posted in Breast Asymmetry, Breast Lift, Breast Revision Surgery, Capsulectomy, Implant Removal


XL Breast Augmentation

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This 35 year old was looking for the best plastic surgeon to perform her breast revision surgery and give her the XL breast implants she wanted.

breast asymmetry

She had some breast asymmetry that she also wanted addressed during the revision breast surgery.

XL breast implants

revision breast augmentation

Markings and measurements are performed and the procedure as well as the patient’s goals are discussed in detail with the patient.

breast implant removal

Above photo shows the patient after removal of breast implants-  she had 800cc silicone gel breast implants.

silicone gel breast implants

Immediately after surgery, her 800 cc silicone gel breast implants were replaced with saline overfilled breast implants (1100 right side/ 1140 left side)

XL breast augmentation

saline overfilled breast implants

The patient is very pleased with the early results of her surgery.

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Posted in Overfilled Saline Breast Implants, XL Breast Augmentation


Breast Lifting Surgery

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This 37 year old, mother of 2 was interested in breast surgery.  She was referred to Dr. Pousti by her friend due to his experience with breast surgery procedures. She was interested in improving the position of her breasts.  After having children, she found that they were no longer “perky” and she wanted that fixed.

breast ptosis

Her nipple/areola pointed downward and so breast lifting was discussed with the patient. The breast lift would reposition the breast tissue and move the nipple/areola complex up to be centered on the breast mound.

saggy breasts

The patients goals were discussed in detail and the patient proceeded to the operating room for breast lifting surgery.

breast lifting

Immediately after mastopexy surgery (below) with the nipple areola positiioned nicely on the breast mound.

mastopexy

braest lift

The incisions will continue to heal, flatten and become less dark during the first 12-18 months after surgery.

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Posted in Breast Lift



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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