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San Diego Cosmetic Plastic Surgery

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Breast Revision Surgery Patients

Bottoming out

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This 35 year old nurse had been thinking about revision breast surgery for 2 years.  Her implants were too low and would fall into her armpits.  She also wanted “more fullness”.

capsulorrhaphy

silicone gel implants

After examination, it was determined that the patient would benefit from capsulorrhaphy (internal bra) to address her bottoming out and lateral breast implant mal-position.

revision

Markings and measurements are performed prior to surgery.  The green arrows indicate where the patient wants more fullness. The internal bra is performed on the lateral and inferior poles of the breasts.

revisioan breast surgery

re-augmentation

 

Above photos show the patient in the operating room after breast implant removal and capsule adjustments made.

 

revisionary

Immediately after breast augmentation revision and internal bra procedure with Mentor Ultra High Profile 590cc Silicone gel breast implants.

revisionary surgery

 

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


Removal of Bilateral Breast Implants, Bilateral Mastopexy

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This 47 year old patient previously had breast augmentation surgery with Dr.Pousti in 2009 but now was at a point in her life where she wanted to have her breast implants removed.

bilateral breast implant removal

Because of the great experience she had with Dr.Pousti previously, she returned to him for her breast revision surgery.

removal of implants and lift

After examination and discussion of goals, it was determined that it would be in her best interest to remove the breast implants and also perform a breast lift.   Markings and measurements were performed prior to surgery and used as a road map during the procedure

bilateral mastopexy

implant removal

Above photo shows her breast implants that were removed during the surgery.

mastopexy

Above photo shows the right breast implant removal and mastopexy performed – compared to left side (not yet operated on).

removal of bilateral implants

lift

Immediately after removal of breast implants and full mastopexy surgery.

 

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Posted in Breast Lift, Implant Removal


Revision Breast Surgery / Internal Bra / Double Bubble

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This 37 mother of 4 had been thinking about breast augmentation revision surgery for over a year.  She was unhappy with the size and placement of her breasts.  She also wanted to address her “double bubble” .

overfilled saline filled implants

After multiple email communications, she was comfortable with Dr. Pousti’s expertise in regards to breast revision surgery.

saline implants

After examination, it was determined that saline overfilled breast implants would be needed to achieve her XL breast size as well as the internal bra procedure (capsulorrhaphy) to address the double bubble and for better positioning of the breasts on her chest wall.

revision

Markings and measurements were performed prior to surgery and the potential risks and complications were discussed.

saline overfill

implant exchange

revisionary

 

 

Immediately after revision breast surgery with saline overfilled breast implants – 1140cc on left side – 1200cc on the right side.

 

 

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


Breast Asymmetry / Pectus Excavatum

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This 21-year-old patient previously had breast surgery (with a different surgeon) to address her breast asymmetry but was not pleased with the results.  She decided to find the best plastic surgeon to help her with her case of pectus excavatum and breast asymmetry.

re-augmentation

The previous surgeon had placed a breast implant on the right side only to improve the symmetry.  After examination and discussion of goals, Dr. Pousti discussed the use of different sizes and profiles of breast implants to improve the breast asymmetry.

silicone gel implants

The patient was very pleased with Dr. Pousti’s expertise in regards to revisionary breast surgery and proceeded to book surgery.  Prior to surgery, markings and measurements were made (below) and the procedure was discussed in detail with the patient.

revision surgery

In pectus excavatum, also known as funnel chest, the sternum (breastbone) is depressed relative to the rest of the chest wall. You can see that depression in the photo below.

removal of right breast implant

Breast implants can be used to camouflage mild to moderate pectus excavatum.

revision

capsulorraphy right medial breast

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Posted in Breast Asymmetry, Breast Revision Surgery, Pectus Excavatum


Breast Implant Removal / Full Breast Lift- 1st stage

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This 26 year old patient from New York was interested in breast augmentation revision surgery.  She searched for the best plastic surgeon to help her with her revisionary breast surgery goals.  She was willing to fly in to have surgery.

revision

She was not happy with the breast asymmetry or how her current breast implants were positioned on her chest wall.

revision surgery

After meeting with Dr. Pousti and discussing her goals, it was determined that performing surgery in stages would be her best option.  The 1st stage would involve breast implant removal and breast lift.

lift without implants

The patient agreed with the plan and proceeded to book her surgery date.  Prior to surgery Dr. Pousti performed measurements and markings and discusses the procedure in detail with the patient.

lift

Above photo shows the dramatic difference between the 2 breasts (right breast implant removed).

mastopexy

revisioanry surgery

implants removal

Immediately after Breast Implant Removal and Anchor Mastopexy.  This surgery will provide a solid foundation for her 2nd stage procedure down the line.  The incision lines will smoothen out and flatten out as they continue to heal.

 

 

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Posted in 2 Stage Procedure, Breast Lift, Implant Removal


Revision Breast Surgery with Internal Bra

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This 44 year old patient has been interested in a revision breast surgery for several months. She was unhappy with her breast asymmetry and wanted more volume.
saline implants
After searching for the best plastic surgeon online, she decide to fly in to have her revisionary breast surgery performed in San Diego by Dr. Pousti.
capsulorraphy implant exchange
revision surgery
She will exchange her current breast implants and also have the internal bra procedure for better placement of her breast implants on her chest wall.
revision
revisionary
revisioanry surgery
She is now post op bilateral revision breast augmentation and bilateral capsulorrhaphy (inferior and lateral). She currently has Mentor smooth, rough, high profile 650cc saline implants.
Patient’s Story:
My story and pics (I haven’t taken the best pics, but will post what I have and try to update with new ones regularly as the swelling goes down): I had my first BA in 2002 with 350cc saline implants. They were great and I loved them for many years, however after 15 years I had lost upper pole fullness and had some lateral implant displacement. It was time for an upgrade. I found Dr. Pousti through real self and just implants forum. All the reviews were positive and after researching, I learned he has a great deal of experience with revisions. I called his office and asked some questions on a couple of occasions. I live in Colorado, so planning for appointments and surgery out of state required asking many questions and more planning than a local operation. They were very helpful in answering all my questions. I submitted my goal pictures and current pictures. I was then sent a recommendation with the caveat that the plan may change slightly after an in person pre-op appointment. I received the recommendation and a quote for the procedure. I then called the office, paid my deposit and confirmed a surgery date. On 9/26, I arrived in San Diego and had my pre-op appointment on 9/27. All of the staff was very helpful and Dr. Pousti spent a good bit of time with me to understand my desired results. As you can see in my goal pics, I wanted upper pole fullness and like the round look. However, I am larger than the girls are in my goal pics and have more of my own breast tissue. Therefore, Dr. Pousti indicated he could get me close to, but not exactly that look. I was fine with that, but concerned about being too big. I am a manager in a conservative industry/workplace and I said I have to be able to wear suits, be professional, not distracting with enormous boobs. The possibility of needing 800ccs had come up and that had me looking like a deer in the headlights! We talked more and determined I should focus on the results I want and not get hung up on numbers. I trusted in Dr. Pousti’s experience and that he had heard what I did and did not want as a result. Time to go get dinner, fill prescriptions, and count sheep waiting to wake up the next morning for surgery. 09/28, I arrived at the surgery center. Filled out paperwork, got changed into surgical gown, vitals taken, and IV put in. They gave me a nice warm blanket and allowed my husband to hang out with me while waiting to go back. I was seen by Dr. Pousti and some of his staff that would be assisting. We discussed the procedure, desired outcomes, etc. again. He then marked me for surgery. Next, I met the anesthesiologist. I was then escorted to the operating room, where I got settled on the table and was quickly knocked out. I woke up in recovery quickly. The nurses were actually surprised at how alert I was so soon after surgery. I saw Dr. Pousti and he let me know that all went well and he thought I would be very happy. I was not in much pain due to all the drugs in my system and left the surgery center about an hour later. I peeked under the edge of the bra and saw that my left breast was 650cc and my right 680 cc. Getting in and out of the car was slow and I was glad the hotel was not too far away. I had asked for extra pillows since I had to sleep sitting up. I took my meds regularly and tried to rest with a few short excursions to get out of the hotel room. My husband stayed in San Diego until Sunday so I was on my own for a few days before my post op appointment on 10/3 and flying home on 10/4. The meds controlled my pain for the most part. The toughest part is not reaching out or over your head. Not being able to wash your own hair or blow dry it is annoying and getting dressed can be a little challenging to cover the bolster dressing. I flew home 10/4 and was back at work 10/5. The next week I flew out on a business trip with a hectic schedule involving all day sessions and evening functions. I had to pay people to help with my bags, had a letter for TSA & the airlines about not being able to lift or raise my hands overhead. If you will have travel, remember to ask for a letter from the Doctor. I made it through the trip, but honestly would not recommend jumping in full steam so soon. When I got home, I was exhausted and spent a whole weekend catching up on rest. I hit three weeks this past week and was able to remove the bolster bandage. I was so glad to get that off after three weeks. It was not as bulky as I had expected during pre-op descriptions, but the tape started irritating my skin and the pads were a bit funky. Getting these off and cleaning up was a boost for that day. I also got to drive myself to work for the first time at the three-week mark, which was a nice milestone in recovery. I am just over three weeks now. What to expect? I still have steri strip bandages so sponge baths vs. showers. Still no lifting overhead, reaching out, or lifting more than 5 pounds. So inconvenient and can get frustrating. The good, I have been off pain meds for a while, I am up to 4 miles of easy walking, and my energy at this point has returned. My right is still very sore and lets me know if I do too much. My left is much better. However, I still have a lot of swelling which is to be expected this early in recovery. If you are looking at planning this surgery here are some tips – 1) clear your calendar as much as possible for 2-3 weeks after the surgery to allow the ability to rest when needed 2) take Colace and eat high fiber nutritious foods post-surgery 3) switch to non-narcotic pain meds as soon as you can. 4) I was very bloated after surgery and still feel a bit bloated. Be prepared for this and stay off the scale for a few weeks. My results – I think I am going to love them, but cannot really see what the final outcome will be yet. I got measured yesterday and with current swelling, I am at 34DDD (at Soma). I was wearing 36D before the procedure. So after swelling goes down expect I will be a perky 34DD or perhaps still a 34DDD. I already love the cleavage I have and the fullness. Cannot wait for them to heal and see the true final results! Being out of state, the doctor’s office called me daily for the first few weeks and now I call and talk to them 2-3x a week as questions come up. They have been amazing answering my questions and calling back quickly if they need to discuss anything with Dr. Pousti before answering. Excellent customer service, very sympathetic and caring regarding how I was doing and addressing any concerns as they came up. I will post update pics after the steri strips are removed later this week and update pics once I can start wearing normal bras/more of my clothes.

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Posted in Breast Revision Surgery, Capsulorrhaphy (Internal Bra)


Double Bubble – Breast Augmentation Revision Surgery

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This 49 year old had her breast augmentation surgery over 15 years ago performed by another surgeon.  She was not pleased with the size, shape or placement of the breast implants. She wanted revision breast surgery.

breast re-augmentation

She wanted them “more round and perky” and wanted to address the “double bubble” and “rippling”.

capsulorraphy

After examination, it was determined that this patient would benefit from breast augmentation revision with saline overfill breast implants and capsulorrhaphy.  The internal bra would help with better placement of the implants on her chest wall.

correction of double bubble

Markings and measurements are very important – Dr. Pousti takes his time prior to surgery to discuss the procedure as well as potential risks and complications associated with the revisionary surgery with the patient.

bilateral breast capsulorraphy

double bubble

Above photo shows the patient with the markings and measurements. You can see the double bubble deformation.implant exchange

revision surgery

The green arrows indicate where the patient wants more “fullness” and the red “X” is where internal work is performed and the ## on the left breast is the double bubble where the pocket needs to be adjusted.

revision bilateral breast augmentationBelow shows the patient immediately after breast augmentation revision with overfilled 1200cc saline implants and internal bra.  You can see the significant improvement.

revision

revisioanry surgery

 

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


Breast Revision Surgery – 2- Staged Procedure

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This 35 year old patient from Connecticut was interested in having breast revision surgery.  She was not happy with the size, shape or position of her breasts.  She researched for the best plastic surgeon for her who specializes in breast augmentation revision surgery.  She found Dr. Pousti and decided that she would fly in to have surgery.

 

bilaterl breast mastopexy

After examination and discussion of goals, it was determined that she would benefit from a 2-staged procedure.

removal of implants (2)

The first surgery would  involve breast implant removal and full breast lifting surgery to create a solid foundation for future surgeries.  Below you will see that Dr. Pousti is taking measurements and marking the patient for surgery.

bilateral mastopexy

removal

Above photo show the patient ready to proceed with her first surgery of breast implant removal and mastopexy.

 

mastopexy

Removal of the capsule during the operation as well as the breast implant – giving the patient a dramatic change

bilateral mastopexy (2)

Below photo shows the breast implant removal as well as capsules that were removed.

breast procedure

removal of implants

removal of bilateral breast implants

Above is the patient immediately after her 1st breast revision surgery with breast implant removal.  The patient was very happy with the results of this surgery.

2nd stage

A year or so later, she communicated with Dr. Pousti regarding having breast augmentation surgery.  She and Dr. Pousti discussed silicone gel breast implants for her breast surgery.

breast augmentation

DSC09917

Her 2nd stage procedure is shown below with 590cc silicone gel breast implants. Patient is so happy!

BA

secound stage

reduction lift, breast augmentation

breast reduction, revision,breast augmentation

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Posted in 2 Stage Procedure, Breast Revision Surgery


XL Breast Augmentation Revision

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This 24 year old patient previously had breast augmentation surgery but was now interested in the XL breast implant size.  She had been thinking about revision breast surgery for quite some time and finally decided to proceed.

re-augmentation surgery

She researched for the best plastic surgeon to perform her breast augmentation revision and found Dr. Pousti.

revision surgery

remove replace

Markings / measurements were performed (above) and during the surgery breast implants removed (below)overfilled saline implants

revisionary surgery

implant exchange

capsulorraphy

Immediately after breast revision surgery with 1650cc overfilled saline breast implants.

 

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Posted in Breast Revision Surgery, Implant Exchange, Overfilled Saline Breast Implants


Breast Implant Removal

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This  48 year old patient had breast augmentation elsewhere and had been thinking about revisionary surgery for a few years.  She no longer wanted to have breast implants and so was looking for an experienced plastic surgeon for breast implant removal.

removal of implants

After meeting with Dr. Pousti, it was determined that the patient was a good candidate for removal of her breast implants and Dr. Pousti recommended a benelli breast lift on the left side to improve breast asymmetry.

breast implant removal

The patient agreed and proceeded to book her surgery date.  Below shows the “markings” and measurements that are performed prior to surgery and serve as a “road map” during the operation

lift

Below shows the silicone gel breast implants that were removed from the patient.bilateral implant removal

mastopexy

lift without implants

Above shows the patient immediately after breast implant removal and benelli breast lift of the left breast.

 

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



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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