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Case Number 4107: Breast Revision, Labia Reduction, and Hernia Repair

This 27 year old patient from Ramona, California was interested in several cosmetic procedures after giving birth. She found Dr. Pousti online and was very impressed with his mommy makeover procedure results. She expressed to Dr. Pousti during her visit that she was extremely unsatisfied with the results of her previous breast augmentation performed by another surgeon. She was also uncomfortable with her excess labia minora tissue and was interested in a labia reduction as well as an abdominal hernia repair.

Breast Revision Surgery San Diego

Dr. Pousti examined the patient and felt the patient was a great candidate for a mommy makeover, which usually consists of several combined procedures. He confirmed the patient had capsular contracture of her right breast implant, capsulorrhaphy, and breast re-augmentation was needed to achieve the patient’s goals. Dr. Pousti determined the patient was a great candidate for a labia minora reduction as well as repair of the abdominal wall hernia.

Revisionary Breast Surgery

Dr. Pousti and the patient met several times prior to surgery to discuss the surgical plan and post-operative care. Dr. Pousti performed markings of the breast and abdomen in the office with the patient.

Breast Revision Specialist

These markings are done in a full length mirror so the patient can communicate her goals and concerns.

umbilical hernia repair

Dr. Pousti meets with the patient again in the surgery center to reinforce markings and make any necessary changes before surgery.

capsular contracture

A small incision is made along the areola and the patient’s previous breast implants are removed. During removal A small incision on the areola was used to remove the patient’s previous breast implants. A capsulotomy was performed to remove the scar tissue around the right breast implant, releasing the tension around the implant caused by capsular contracture or encapsulation. Capsular Contracture can distort the shape and firmness of the breast causing severe pain to the patient.

implant removal

Once the breast implants and scar tissue were removed, Dr. Pousti performed Capsulorrhaphy or internal suturing to repair the patient’s breast pocket. Capsulorrhaphy was performed on the left breast pocket both inferior and lateral to improve symmetry between two breasts.

breast implant exchange

After the breast revision is complete, sizer implants are used to determine implant sizing. The sizer implants are placed into the breast pocket and filled with air until the patient’s desired goal size has been achieved. The patient is sat upright several times throughout this process to check for symmetry and fullness. This allows Dr. Pousti to make any changes necessary prior to final implant placement. The sizer implants are then removed and the patient’s silicone gel implants are prepped for placement using the Keller Funnel method.

implant sizers

The Keller Funnel method uses a sterile oily funnel to easily squeeze the implant into the breast pocket using a no touch method, reducing the risk of contamination. Dr. Pousti used a 533cc silicone gel implant on the right breast and a 492cc silicone gel implant on the left breast. Different size implants are sometimes needed to achieve better symmetry and can be determined when using the sizer implants.

breast revision

A labia reduction was performed to remove the excess minora tissue that can cause discomfort during exercise, intercourse, walking/or sitting and other daily activities. The procedure consists of achieving symmetry with the inner lips of the vulva while being cautious to not interfere with the clitoris and urethral opening.

labia rejuvenation

The patient is extremely happy with her results.


4 weeks






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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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