Breast Procedures Patients

This 41 year old patient from Corpus Christi, Texas had been unhappy with the size and shape of her breasts for several years. After extensive research she knew she was interested in proceeding with cosmetic surgery. The patient was interested in finding a surgeon around her area until she came across Dr. Pousti’s website. She was impressed with the amount of information and pictures he provided and decided that it was worth the trip to come to California for him to perform her breast surgery.

The patient had been in contact with Dr. Pousti via phone and email and expressed her concerns and expected results. Dr. Pousti was able to answer all her questions and give her options to choose from.

After being examined it was determined that the best option for the patient would be a breast lift along with augmentation. Measurements of the patients chest were taken prior to surgery and markings of the breast procedure were made.

The ‘x’ markings on the breast indicate where the nipple/areola complex should be expected to be when the breast lift is completed. Once the nipple/areola complex is relocated the skin underneath is removed and the breast tissue is rearranged to give the breasts a more firm and perky look.

Sizers are then placed, filled with air and the incisions are temporarily closed. The patient is then placed in an upright position to make sure that her goals are being met.

275cc Silicone Gel implants were used in the patients breast to achieve the look she was going for.

The patient is post op breast augmentation/mastopexy with silicone gel implants and is very happy with her initial results.

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Posted in Breast Augmentation, Breast Lift, Breast Lift with Implants, Breast Procedures, Silicone Gel Implants

This 22 year old patient from San Diego, California had breast augmentation surgery performed by a previous surgeon and was left with unsatisfactory results. The patient was not happy with the overall appearance of her breasts but the breast shape bothered her the most. She did not feel comfortable returning to her previous surgeon and knew that she would have to do research to find a surgeon that was experienced with revisionary breast surgery. During her search she came across Dr. Pousti several times and was very impressed with the vast amount of experience he had with breast revision procedures.

Upon examination it was apparent to Dr. Pousti that the patient had a severe case of ‘Symmastia’. Symmastia occurs when the skin near the cleavage area separates from the sternum; causing the implants to be malpositioned medially. This can cause the breasts to form a ‘bread-loaf‘ appearance.

The patient and Dr. Pousti meet several times prior to the revisionary breast surgery to discuss options and go over the procedure in detail. In this patient’s case the best option was to go with symmastia repair and an implant exchange. The first step of this surgery is to take measurements of the patients chest and mark the areas where correction is needed.

When the patient is in the operating room she is placed in an upright position and markings are re-checked. If any adjustments are needed they are done at this time. The red area indicates where the symmastia repair will need to be done.

The patient’s current breast implants are taken out through a small incision along the areola. To avoid additional scaring the previous incisions were re-used. Once the implants are removed Dr. Pousti begins work on the ‘breast pocket’. A breast pocket is an open pocket created under the muscle where the breast implants sits.

During symmastia repair Dr. Pousti uses internal sutures to re-attach the skin to the sternum in the center of the patient’s chest. Sizers are then used to determine the size of the implant Dr. Pousti will need to use in order to achieve the patient’s desired look.

300cc Silicone Gel Implants were used in both breast to meet her goals.

As you can see when the patient is in a lying down position the symmastia correction has improved the appearance of the chest and the patient no longer has ‘tenting‘ present.

After the procedure is completed, bolster dressings are applied. The dressings help add support to the internal sutures and help ensure that implant malplacement does not reoccur.

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A “thong bra” is then given to patient to wear post surgery and is used to stabilize the area after symmastia reconstruction. This will allow the sutured area between the breasts to heal properly without excessive pressure being applied.

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Posted in Breast Augmentation, Breast Pocket Correction, Breast Procedures, Breast Revision Surgery, Silicone Gel Implants, Symmastia

This 38 year old from Chula Vista, California was unsatisfied with her breast augmentation performed by a previous surgeon. She was interested in revisionary breast surgery but was very cautious about having another surgery performed. She decided it was a good idea to research more and find a board certified plastic surgeons with experience. The patient had heard about double board certified Dr. Pousti from numerous people and decided to research about him and his practice. She was surprised by the amount of information regarding revisionary breast surgery displayed throughout Dr. Pousti’s many websites.

During her consultation, she was able to meet and talk with other patient’s of Dr. Pousti’s who underwent revisionary breast surgery. She couldn’t believe the phenomenal results Dr. Pousti was able to achieve for his patients and how happy they were with their surgical results. The patient’s fears were diminished and she completely trusted Dr. Pousti to perform her surgery. Upon examination, Dr. Pousti felt the patient had accumulated scar tissue that needed to removed and the patient would need internal sutures and an implant exchange.Dr. Pousti carefully performed markings and measurements to achieve symmetry and to correct the current problems. During this time, he also discussed the procedure to the patient from the start of the surgery to her recovery.

The red area indicates where the patient desired more fullness

Dr. Pousti met with the patient again the morning of surgery to reinforce markings and to discuss the procedure with the patient again. He also will answer any questions the patient may have and will try to make the patient feel as comfortable as possible.

Below you can see when the patient is lying flat, her implants will fall to the sides. Internal sutures will be used on the outer portion of the patient’s breasts to correct the malplacement issue.

In the operating room, Dr. Pousti uses temporary sizer implants. This allows him to adjust the implant in size until he reaches the patient’s desired look. Once this has been achieved, the sizer implant is removed, and the permanent implant is placed.

Below you can see, Dr. Pousti has removed the sizer implant and will now prepare and administer the patient’s permanent implant.

After the implants and scar tissue have been removed, Dr. Pousti will tighten the breast pocket using internal sutures. Capsulorrhaphy, the use of internal sutures, will correct the breast pocket preventing the implants from falling to the side and will restrict the patient’s breast implants from falling to the side.

490cc Silicone Gel Implants were used in the patient’s breast o give her the look she wanted. She is extremely happy with her breast revision results.

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Posted in Breast Augmentation, Breast Procedures, Internal Bra (Internal Sutures), Silicone Gel Implants

This 33 year old from Santee, California was interested in a breast augmentation and breast lift combined surgery. She was referred to Dr. Pousti by a friend and a previous satisfied patient of Dr. Pousti’s. She was able to see Dr. Pousti’s work first hand and decided to schedule a consultation to meet with him. During her consultation, she was able to meet with other patient’s of Dr. Pousti’s who had previously underwent breast augmentation/breast lifting procedures to ask them questions and to see their results. The patient was very impressed with Dr. Pousti and his skills as a cosmetic surgeon. She was ready to continue with her surgery .

The patient met with Dr. Pousti again prior to her surgery. During this time markings were performed to ensure symmetry is met and her desired goals are achieved. During this time, the patient was encouraged to bring in photos of breasts that she wanted to achieve post surgery. These pictures are hung up on the wall in the operating room and used as a guidance for Dr. Pousti throughout the procedure to guarantee the patient’s desires are met.

Before Breast Augmentation/ Breast Lifting

Dr. Pousti carefully measures and marks the patient and uses these as a guide during surgery. The “x” indicates the area where the nipple will be post surgery.

After Breast Augmentation/ Breast Lifting

During the procedure, Dr. Pousti uses sizer implants. This allows him to temporarily place an implant and fill it to a size that fits the patient’s goals. He then removes the temporary sizer implants, and places the permanent implant.

Before Breast Augmentation/ Breast Lifting

After Breast Augmentation/ Breast Lifting

450cc Saline Implants were used in both breasts to achieve the patient’s desired look.

The patient is now 5 days post-op and is very happy with her results.

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Posted in Breast Augmentation, Breast Lift, Breast Lift with Implants, Breast Procedures

This 30 year old from Apple Valley, California was interested in revisionary breast surgery. She was unsatisfied with her results from her previous surgeon. She did not like the shape, size, or placement of her breast implants and she also suffered from implant malposition resulting in symmastia. She researched the internet for experienced breast revision surgeons and found Dr. Tom Pousti. After reviewing many symmastia and breast revision repair cases, she felt optimistic that he would be able to achieve the same results with her and decided to drive to see Dr. Pousti.

Upon examination, Dr. Pousti determined the patient not only had symmastia, but “bottoming out” of her implants as well. Symmastia appears when two implants are touching one another often creating a “uni-boob”. Symmastia often happens if the horizontal muscle that is connected to the sternum is cut during surgery and after overly aggressive attempts to achieve cleavage are made.

The patient and Dr. Pousti met again to discuss the procedure in detail along with recovery. Markings were done the night prior to surgery and were reinforced the morning of surgery. In order to achieve her desired look, internal sutures were used to repair her cleavage area and to also create an “internal bra” for the new position of the implants and to fix the bottoming out of the implants.

Dr. Pousti removed the patient’s previous implants through a small incision of the areola.

Immediately After Symmastia and Bottoming Out Repair

He replaced the patient’s previous implants with 475cc Silicone Gel Breast Implants. After repairs were made, the patient has two distinct breast pockets.

Bolster dressings are worn for several weeks to protect the repaired area during recovery.

The patient is very happy with her results.

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Posted in Breast Augmentation, Breast Procedures, Breast Revision Surgery, Internal Bra (Internal Sutures), Silicone Gel Implants, Symmastia

This 34 year old from Santee, California was interested in a breast augmentation for several years. She was referred to Dr. Pousti by a close friend and was very impressed with the results Dr. Pousti was able to achieve for his patient’s displayed on his website. After reviewing several cases on the internet, she decided to  meet with Dr. Pousti.

During her consultation, she met with several other patient’s of Dr. Pousti to see their results first hand and hear about their experience with Dr. Pousti and his staff. After hearing all the great reviews, she felt even more comfortable. Dr. Pousti determined that the patient would be a good candidate for breast augmentation as well as a limited breast lift. Upon examination, he also suggested to create better symmetry the patient should consider an areola reduction along with her breast enhancement and benelli lift procedure. After careful consideration, she wanted to continue with surgery.

Markings and measurements were performed prior to surgery. During this time, Dr. Pousti is able to explain the procedure to the patient in detail and go over pre-operative and post-operative care. All the risks and complications associated with surgery are also reviewed with the patient.

The markings indicate where the patient would like to see cleavage on her chest and where she would like the fullness to be achieved. Markings are extrememly importation for not only Dr. Pousti, but for the patient to understand what will be achieved after surgery. Below, Dr. Pousti demonstrates where the nipple/areola complex will be located after the implants have been placed below the muscle. He will also reduce the size of the areola during the breast lift to achieve better symmetry between the breasts and areola.

Dr. Pousti encouraged the patient to bring in photos of breasts she “likes” as well as “dislikes”. The poster helps him to narrow down the patient’s goals and clearly communicates what she wants to achieve. The patient wanted a natural look, with cleavage and some fullness on top. She didn’t want her breasts too far apart with outer cleavage.

Before Breast Augmentation/Areola Reduction

After Breast Augmentation/Areola Reduction

Dr. Pousti used 450cc Smooth Round Moderate Plus Profile Silicone Gel implants to achieve the patient’s desired look. The patient is now 1 week post-op at is extrememly satisfied with the results of her breast enlargement, breast lift, and areola reduction.

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Posted in Aerola Reduction, Benelli Lift, Breast Augmentation, Breast Lift, Breast Lift with Implants, Breast Procedures, Silicone Gel Implants

This 39 year old from Chula Vista, California had been interested in revisionary breast surgery. She had experienced a deflation to her right breast implant and was extrememly unsatisfied with the unevenness of her breasts. The patient understood the importance of finding a board certified surgeon and after researching the internet she found double board certified surgeon, Dr. Pousti. She felt his experience with removing and replacing implants outweighed that of any other surgeon.

The patient met with Dr. Pousti several times, and wanted him to perform her breast re-augmentation procedure. Dr. Pousti discussed all of the risks and complications associated with a breast revision surgery.

Before Implant Exchange

The asymmetry of the patient’s current breast implants are extrememly noticeable. Even while the patient was wearing clothes, she felt extrememly uncomfortable.

Once the patient is in the operating room her previous breast implants are removed through a small incision along the areola. Sizers are then set in the breast pockets to determine the size of the breast implant need to meet the patient’s desired look.

After Implant Exchange

Dr. Pousti replaced the patient’s previous implants with 600cc Silicone Implants. The patient is still very fresh from surgery but is extremely happy with the results of her revisionary breast surgery.

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Posted in Breast Asymmetry, Breast Augmentation, Breast Procedures, Breast Revision Surgery, Implant Removal, Silicone Gel Implants

This 30 year old from Panorama City, California had breast augmentation performed previously and was interested in breast revision surgery. She wasn’t comfortable returning to her previous surgeon and understood the importance of researching for a new one. She searched the internet for experienced plastic surgeons in California and kept coming across Dr. Pousti’s website. She finally decided to schedule a consultation to meet with him and discuss her options. Her main concerns were her implants settling to the side, asymmetry, shape and overall appearance of her breasts.

During her consultation, she was able to  meet with Dr. Pousti’s previous patients who had revision breast surgery performed by him and was able to ask them questions and see their results. After hearing how pleased all of Dr. Pousti’s patients were with their surgical results, she knew she had found the right surgeon.

Measurements and markings were performed prior to the procedure to promote symmetry and more pleasing results. Upon examination it was determined that the patient’s best option was an implant exchange with capsulorrhaphy. The capsulorrhaphy procedure, also known as pocket correction or use of internal sutures/bra, involves closing a portion of the breast pocket to correct displacement of the implant.

The purple arrows indicate where the patient desired more breast fullness.

Dr. Pousti rechecks the markings of the patient’s breast multiple times prior to surgery and adjustments are made if needed.

Once the patient is in the operating room her previous implants are removed and Dr. Pousti begins work on the breast pockets. The pockets are opened up more towards the center of her chest to help achieve the cleavage she desired. Then internal suture repairs are done on the outer sides of the breast to correct implant malplacement.

After pocket correction is completed sizers are used. Dr. Pousti is able to fill the sizer implants to the patient’s desired look. Once the amount of volume the patient wants is achieved, the sizer implants are removed, and the permanent implants are placed with the correct amount of volume.

Before Breast Revision Surgery/After Breast Revision Surgery

Immediately after surgery, it is apparent the internal suture repair has allowed the implants to sit comfortably towards the center of the patient’s chest rather than falling to the side.

Before Breast Revision Surgery/After Breast Revision Surgery

Before Breast Revision Surgery/After Breast Revision Surgery

Dr. Pousti used Smooth Round Moderate Plus Profile Gel Breast Implants filled to 800cc to achieve the patient’s desired look.

The patient is now 1 week post-op and is very satisfied with her results.

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Posted in Breast Pocket Correction, Breast Procedures, Breast Reconstruction, Breast Revision Surgery, Internal Bra (Internal Sutures), Silicone Gel Implants

This 29 year old patient  from San Diego, California was interested in a breast augmentation, thigh lift, and liposuction of her outer thighs. She had completed an extended abdominoplasty and breast lift with Dr. Pousti previously and was ready to go forward with the second stage of her surgery.

After loosing a combined total of 122 pounds, the patient was ready to begin the rest of her transformation. After having her tummy tuck and breast lift completed, the patient was very pleased with her results. She felt she was ready to continue with her breast enhancement and thigh lift surgery.

Once healed from her extended tummy tuck and mastopexy, Dr. Pousti and the patient decided to proceed with the second stage. After meeting with Dr. Pousti and getting the approval to continue with her next procedures, the patient and Dr. Pousti met to perform markings of her inner and outer thighs as well as her breasts.

In the operating room, Dr. Pousti removes as much excess skin as possible with combined liposuction to contour the thighs as much as possible.

After the thigh lift portion is completed, it is very evident the thighs are appear fresh and tight.

Below, you can see the fat after liposuction has been performed on the outer thighs.

Dr. Pousti used Smooth Round MPP Silicone Gel Breast Implants filled to 600cc on the right and 550cc on the left. The left breast was slightly larger than the right, so the right breast has a larger implant.

The patient is extrememly satisfied with the addition of her breast augmentation, thigh lift, and liposuction.

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Posted in Breast Augmentation, Breast Procedures, Liposuction, Silicone Gel Implants, Thigh Lift

This 35-year-old patient from Fredericksburg, Virginia had breast augmentation performed many years ago by a previous surgeon and was unhappy with her results. She decided to look into surgeons that were not only board certified in plastic surgery but also experienced with revisionary breast surgery. She came across Dr. Pousti’s website and was very impressed with his before and after pictures as well as his credentials and experience. She knew he was the right surgeon for her breast revision surgery and knew the travel from Virginia to California would be worth it.

During her correspondence with Dr. Pousti via phone and email the patient expressed to him her dissatisfaction with the size and shape of her breasts. She was interested in implant exchange with larger implants and desired more upper fullness.

A small incision is made on the areola and sizers are set in place to help determine the size of the breast implant needed to meet the patient’s size goals. The patient is placed in an upright position several times over the duration of the breast procedure to make sure symmetry is achieved.

In order to give the patient her desired look 650cc Silicone gel implants were used in both breasts. The patient is extremely happy with the results of her surgery.

Immediately After Revisionary Breast Surgery in Operating Room

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Posted in Breast Augmentation, Breast Procedures, Petite Frame Breast Augmentation, Silicone Gel Implants, Uncategorized