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Breast Asymmetry Patients

Breast Reduction

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This 22 year old mother from Victorville, California had been interested in a breast reduction for years. She never thought she would be eligible for the procedure, but after years of the pain and inconvenience she was having, she decided to visit double board certified plastic surgeon, Dr. Tom Pousti, to get his expert opinion on how to alleviate her problem. At her consultation, it turned out that she did qualify for breast reduction surgery. before breast reduction and lift
She was given the opportunity to have all her questions answered. She looked through photos of Dr. Pousti’s work and the planned procedure, risks, and complications were discussed. Within a few weeks, she was ready to proceed with surgery.

side view before breast reduction and lift

One of her main goals was to achieve a look that was proportional to her body frame. She wanted to make sure she achieved breasts that fit her personality and body. The goals and outcome of the procedure were discussed on multiple occasions with Dr. Pousti and the patient.

The markings and measurements are performed. The right breast is lifted and Dr. Pousti and team begins the work on the left breast.

breast reduction and lift

The patient is shown below immediately post surgery. 816 grams of tissue was removed all together.

after breast reduction and lift

side view after breast reduction and lift

Testimonial:

Ever since I first heard about Breast reductions, it been something I wanted. I have had large breasts since junior high. My size before my reduction was a 34 DDD…way too big for my frame. I’ve dealt with intense neck, shoulder & back pain for over 5 years. Emotional pain, from being treated like an object, feeling ashamed of my body, I hated the attention my large breasts attracted. I decided to check what my options were about 5 months ago. I called my insurance & asked about three policy on covering a breast reduction. I was told to find a doctor within our network & after some research, I found Dr. Pousti in San Diego. I went in for my consultation & we filled out my application for the insurance to cover the breast reduction. 2 weeks later I received the best phone call of my life, I was fully approved!

Dr. Pousti is a wonderful doctor. He was empathetic & kind when speaking with me & he made sure that I was comfortable & confident with my decision. I would highly recommend him to any woman who is considering a breast reduction.

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Posted in Breast Asymmetry, Breast Lift, Breast Procedures, Breast Reduction, Excision of Bilateral Excess Breast Tissue


Breast Asymmetry

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This 44 year old female from San Diego, California currently has implants from a surgery performed by another surgeon 6 years ago. She is currently unhappy with the size of her areola and the asymmetry present in her breasts. She presented with bilateral breast hypoplasia/ptosis and left implant displacement (inferior and lateral). She desired breast revision surgery. She was referred to Dr. Pousti by a friend and satisfied previous patient who was very happy with the work he had performed. before remove and replace of implants with internal bra, areola reduction, and unilateral breast lift

Dr. Pousti, a double board certified plastic surgeon, met with this patient and discussed the procedure that would best help her achieve her goals along with the possible risks involved. The patient proceeded with surgery. The markings were performed on the morning of the procedure and the patient and Dr. Pousti get a chance to go over the surgery one last time.

side view before remove and replace of implants with internal bra, areola reduction, and unilateral breast lift

After all questions were answered, the patient was taken to the operating room. The patients current implants were removed. Capsulorrhaphy (internal bra) was performed to close off the breast pocket and reduce implant displacement. A stage 1 breast lift was performed on the right breast and a stage 3 breast lift was performed on the left breast. New cohesive gel breast implants were used to help the patient achieve the fullness she desired. The incision lines are closed and the patient is taken to recovery.

remove and replace of implants with internal bra, areola reduction, and unilateral breast lift

The patient is shown below 2 months post surgery. She has 495cc (left) and 595cc (right) high profile Sientra silicone gel breast implants.

after remove and replace of implants with internal bra, areola reduction, and unilateral breast lift

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Posted in Areola Reduction, Benelli Lift, Breast Asymmetry, Breast Lift, Breast Pocket Correction, Breast Procedures, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Limited Lift (Benelli Lift)


Breast Implant Removal and Breast Lifting Surgery

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This 42 year old patient flew in from Cedar Springs, Michigan after extensive research for a board certified plastic surgeon who could help her with breast revision surgery to achieve her goals of more rounded and fuller breasts. She is 7 years post breast augmentation surgery performed by another surgeon but was unhappy with the shape of her current breasts. She performed online research and came across Pousti Plastic Surgery and was very impressed with all the breast revision expertise of Dr. Pousti.Before breast implant removal and amstopexy

She began an online consultation. Dr. Pousti recommended the removal of her current breast implants and also the reduction / lifting of her native breast tissue for better nipple/areola placement and to help achieve more perkiness. After the breast lifting incisions heal, a 2nd stage augmentation would be able to be performed. By performing a 2 stage procedure, the patient will more likely reach her goals.  She decided after speaking with Dr. Pousti that she wanted to proceed with this surgery.

side view before breast implant removal and amstopexy

The markings and measurements for the procedure were performed the morning of the surgery. Dr. Pousti and the patient discuss the planned procedure, risks, and possible complications one final time before proceeding.

markings for breast implant removal and amstopexy

The left breast is temporarily lifted and the work on the right breast begins. Dr. Pousti will do his best to achieve as much breast symmetry as possible.

breast implant removal and amstopexy

The patient is shown below immediately post surgery. Both implants were removed along with 1060grams of native breast tissue. The patient will return in 6-12 months in order to have her breasts augmented.

after breast implant removal and amstopexy

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


Correction of Breast Asymmetry

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This 23 year old female from Texas flew in to have her breast augmentation procedure performed by board certified doctor Tom Pousti. She was extremely unhappy with the breast asymmetry she had her whole life. She desired to improve the asymmetry while achieving more fullness and cleavage in her breasts. Through word of mouth, she came across Dr. Pousti and found his website very helpful in her research. She began communication with Dr. Pousti through email and made her plans to arrive and complete surgery.

before silicone breast augmentation and unilateral breast lift to correct asymmetry

Her consultation visit was held the day prior to her procedure where she got to meet with Dr. Pousti and discuss her goals. Dr. Pousti determined that since her breast asymmetry was so significant, a breast lift as well as breast implants would be performed on her right breast while a straightforward breast augmentation was performed on her left breast.

side view before silicone breast augmentation and unilateral breast lift to correct asymmetry

The markings were performed prior to the procedure.

markings for silicone breast augmentation and unilateral breast lift to correct asymmetry

The excess skin from the right breast is removed and the breast is lifted.

silicone breast augmentation and unilateral breast lift to correct asymmetry

A sizer is used in each breast to help determine what size silicone gel breast implants would be used to help the patient achieve her goals.

sizer for silicone breast augmentation and unilateral breast lift to correct asymmetry

The patient is shown immediately post surgery and has 465cc (right) and 495cc (left) silicone gel breast implants and much improved symmetry.

after silicone breast augmentation and unilateral breast lift to correct asymmetry

Since the patient is from out of state, she will continue to followup with Dr. Pousti via email and pictures.

post silicone breast augmentation and unilateral breast lift to correct asymmetry


Testimonial:

I’ve had asymmetric breast ever since I was a teenager. After our second child I decided it was time for me to become comfortable in my own skin. We were going to California for vacation in June so I figured I would do it in California. I researched doctors who specialize in asymmetry and found Dr. Pousti. From the moment I stepped into his office and met his staff I knew I had made the best decision. He’s an amazing person and a brilliant surgeon. I am so ecstatic with my breasts and breast lift outcome. My breasts are symmetrical and beautiful. I recall being very nervous the day of consult and day of surgery, but Dr. Pousti would come in and put me at ease. He took his time and made sure he knew my goals and went about the best way to achieve them. I had a breast lift on one breast and an implant in the other breast. Post-surgery for weeks after, Dr. Pousti’s staff kept in contact with me making sure I was taken care of and how I was feeling. They have been great at checking on me even when I returned home to Texas. Dr. Pousti has an amazing practice and the best staff. I would recommend him to anyone.

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Posted in Breast Asymmetry, Breast Augmentation, Breast Lift, Breast Procedures


Breast Augmentation Unilateral Breast Lift to Camoflauge Chest Deformity

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This 22 year old female from Oregon flew in to San Diego in order to have her breast augmentation procedure performed by Dr. Pousti. The patient was unhappy with the asymmetry in her breasts and lack of tissue present. She presented with asymmetric breast hypoplasia and significantly asymmetric chest wall with very prominent skeletal structures along the medical aspect of each breast.  She desired to camouflage her chest deformity that occurred due to a lack of pectoral muscle on her left chest wall. She also desired to reduce the size of her right areola to achieve more symmetry.before breast augmentation silicone and unilateral areola reduction

While doing online research for a skilled and board certified plastic surgeon, she came across Dr. Pousti. She found his experience and amount of before and after photos to be very impressive. She began to communicate with Dr. Pousti via email and set up her surgery. She flew in and had her consultation and surgery the following morning.

side view before breast augmentation silicone and unilateral areola reduction

Below, the chest asymmetry is shown.

breast augmentation silicone and unilateral areola reduction

The patient is immediately post surgery and has 285cc (right) and 405cc (left) Sientra Brand Silicone Gel Breast Implants. The right areola has been reduced and the breasts have reached better symmetry.

after breast augmentation silicone and unilateral areola reduction

side view after breast augmentation silicone and unilateral areola reduction

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Posted in Areola Reduction, Areola/Nipple Procedures, Breast Asymmetry, Breast Augmentation, Breast Procedures, Keller Funnel, Petite Frame Breast Augmentation


Mommy Makeover with Use of AlloDerm

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This 35 year old patient from Canyon Lake, California, desired breast revision surgery and an abdominoplasty to achieve better proportions and feel more comfortable in her skin. She was referred to Dr. Pousti through a good friend of hers who is also a very satisfied previous patient. At her consultation, the patient received the opportunity to meet with Dr. Pousti, discuss the procedures of interest, and see hundreds of before and after photos from the double board certified surgeon.

before benelli lift and implant exchange with use of alloderm and abdominoplasty

She was post previous breast augmentation and presented with implant encapsulation, breast asymmetry, and a desire to improve breast size, shape, symmetry, and feel. Dr. Pousti recommended a stage 1 (Benelli) breast lift in order to raise the position of the areola and achieve a better outcome. After 3 pregnancies, the patient presented with excess skin and adipose tissue of abdominal wall associated with abdominal wall laxity.
side view before benelli lift and implant exchange with use of alloderm and abdominoplasty
The markings for the procedure are completed the evening prior to surgery and the measurements are double checked the following morning. The patient is able to express any last minute questions and the procedure is discussed between the patient and the doctor one last time.
markings for benelli lift and implant exchange with use of alloderm and abdominoplasty
The patient was experiencing capsular contracture which is excessive scar tissue buildup around the breast implant post surgery. The cause of capsular contracture is unknown, but it is the most common complication with breast augmentation surgery. There are different grades of capsular contracture ranging from mild to severe.
benelli lift and implant exchange with use of alloderm and abdominoplasty
The rate of capsular contracture has decreased from 20-30 years ago when all breast implants were placed above the muscle (sub-glandular). By placing the breast implants below the muscle (sub-muscular), the rate of capsular contracture has significantly decreased. Also, it is said that massaging of the implants helps decrease the chance of capsular contracture. When a patient is believed to be developing capsular contracture or hardening of the breasts, they may be placed on a medication called Accolate. This is an asthma medication that has shown to improve capsular contracture in patients at an early stage. When a patient develops severe capsular contracture, the treatment would be to return to the operating room and perform a capsulectomy on the patient.
implants from benelli lift and implant exchange with use of alloderm and abdominoplasty
AlloDerm, also known as ADM or is an acellular dermal matrix, derived from donated human skin tissue. Since AlloDerm is regarded as minimally processed and not significantly changed in structure from the natural material, the FDA has classified it as banked human tissue. It has been shown to reduce and even prevent the chance of capsular contracture from occurring.
allograft for benelli lift and implant exchange with use of alloderm and abdominoplasty
The Allograft is placed between the breast implant and the patients skin to add another layer of support.
alloderm for benelli lift and implant exchange with use of alloderm and abdominoplasty
Below, the abdominal muscle is show prior to the muscle correction. The black lines represent where the muscle will be brought together and repaired.
muscle repair for benelli lift and implant exchange with use of alloderm and abdominoplasty
The excess skin is removed to help the patient achieve her goals.
removal of excess skin for benelli lift and implant exchange with use of alloderm and abdominoplasty
The patient is shown immediately post Mommy Makeover and has bilateral 750cc Natrelle Silicone Gel Breast Implants.
before and after benelli lift and implant exchange with use of alloderm and abdominoplasty

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Posted in Abdominoplasty, AlloDerm, Benelli Lift, Body Contouring, Breast Asymmetry, Breast Lift, Breast Procedures, Breast Revision Surgery, Capsular Contracture, Limited Lift (Benelli Lift), Mommy Makeover


Breast Procedures and Body Contouring

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This patient from San Diego, California was interested in breast revision surgery in order to achieve better results due to her unhappiness with her results from another surgeon. She desired to correct the asymmetry in her breasts. Breast asymmetry is a condition where one breast is noticeably larger than the other. Patients may start with different sized breasts before surgery (most patients are not perfectly symmetrical). Some cases of breast asymmetry are more severe than others, but there are several surgical options to promote better symmetry. Different types of implants may be used, different volumes may be used to fill up the breast implants, or changes in the pocket dissection may be used to help achieve as much symmetry as possible.1. Before implant exchange and correction of breast pocket

She was originally referred to Dr. Pousti through internet research for a board certified plastic surgeon who could help her achieve her goals.

1. side view before  implant exchange and correction of breast pocket

The red lines represent where the patient desires to have more upper fullness.

1.  markings before implant exchange and correction of breast pocket

Her current implants are removed.

1. implant exchange for  implant exchange and correction of breast pocket

Dr. Pousti uses new saline breast implants to achieve the size and shape that the patient desired.

1.after  implant exchange and correction of breast pocket

9 months later, the patient decided that she desired to have a larger look.

2. Before adding cc's

She was already familiar with Dr. Pousti and impressed from her previous experience and decided to return to Pousti Plastic Surgery to help reach her goals.

2. side view before adding cc's

Her implants are removed and replaced to achieve 1420cc (right) and 1540cc (left) XL saline breast implants.

2. adding cc's

16 months post her XL breast augmentation surgery, the patient returned and desired to tighten her abdominal muscles through a tummy tuck. Since this is a specialty of Dr. Pousti’s, she again returned to him to help her achieve her goals.

3. before tummy tuck

Post-pregnancy issues are very common. Having a child is one of the most fulfilling experiences a person can have, with new life and energy to any family. Some women, however, feel somewhat self conscious about their new body post-pregnancy with symptoms including stretching or sagging of stomach muscles & skin, sagging or drooping breasts, breast deflation, weight gain in mid-section, thighs, & stomach, excessive fat deposits, and/or C section pouch.

3. side view before  tummy tuck

Dr. Pousti performs the markings for the surgery and discusses the procedure with the patient.

3. markings for  tummy tuck

Below, the abdominal muscle is repaired so that the core of the patient will tighten.

3.  tummy tuck

Her excess skin is removed in order to help her achieve her goals.

3. removal of excess skin for  tummy tuck a

6 months after her tummy tuck procedure, the patient desired to downsize her breasts. Dr. Pousti punctured each breast implant in 2 locations ad allowed the sterile water  of the implants to be absorbed by the body. The patient returned 4 months post that procedure and was ready to have her implants removed. Dr. Pousti recommended a breast lift and revision of her tummy tuck scar. The patient proceeded with surgery.

4. before breast lift, revision of tummy tuck scar, and lipo of abdomen

Again, the patient felt confident is choosing Dr. Pousti to help her achieve her goals.

4. side view before breast lift, revision of tummy tuck scar, and lipo of abdomen

The markings were performed the morning of surgery.

4. markings for breast lift, revision of tummy tuck scar, and lipo of abdomen

The breast is temporarily closed and a drain is put in place to prevent excess fluid buildup.

4. sizer for breast lift, revision of tummy tuck scar, and lipo of abdomen

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Posted in 2 Stage Procedure, Abdominoplasty, Body Contouring, Breast Asymmetry, Breast Lift, Breast Procedures, Breast Revision Surgery, Implant Exchange, Implant Removal, Liposuction, Overfilled Saline Breast Implants, XL Breast Augmentation, implant deflation


Mommy Makeover with Benelli Lift

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This 34 year old patient from San Diego, California, desired to have a mommy makeover procedure performed because she was unhappy with the look of her body after children. While looking online and researching for the most skilled plastic surgeon, she came across double board certified, Dr. Pousti. She came in for a consultation and determined she would be a good candidate for tummy tuck.before mommy makeover- tummy tuck and breast augmentation with stage 1 lift

He also recommended breast augmentation with the use of silicone gel breast implants and a benelli (stage 1) breast lift to help her achieve more fullness and cleavage with perky breasts. She proceeded with surgery.

side view before mommy makeover- tummy tuck and breast augmentation with stage 1 lift

The markings were performed the morning of surgery and the procedure was discussed in details to ensure there was clear communication between the patient and Dr. Pousti.

markings for mommy makeover- tummy tuck and breast augmentation with stage 1 lift

The abdominal muscle wall is repaired to help tighten the core of the patient.

muscle repair mommy makeover- tummy tuck and breast augmentation with stage 1 lift

Below is after the muscle repair is completed.

mommy makeover- tummy tuck and breast augmentation with benelli lift

Excess skin is removed from the patient to help her achieve her goals.

mommy makeover- tummy tuck and breast augmentation with stage 1 lift

The patient is shown immediately post surgery with bilateral 435cc silicone gel breast implants. She will recover for 4 weeks and continue to return to Dr. Pousti for follow-up.

after mommy makeover- tummy tuck and breast augmentation with stage 1 lift

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Posted in Abdominoplasty, Benelli Lift, Body Contouring, Breast Asymmetry, Breast Lift, Breast Procedures, Limited Lift (Benelli Lift), Mommy Makeover


Use of AlloDerm to Correct Implant Displacement and Palpability/Rippling

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This 59 year old patient from Nebraska flew in to have breast revision surgery performed by double board certified plastic surgeon, Dr. Pousti. She was unhappy with the the breast asymmetry she was experiencing. The patients right breast had significantly more volume than the left breast. On her left breast, the patient experienced implant displacement inferior with an area of significant palpability/rippling under her breast.before implant exchange with internal bra and use of acellular dermal matrix

She found Dr. Pousti while researching online for a board certified and skilled surgeon who could help her correct the problems she was having with her breasts.

side view before implant exchange with internal bra and use of acellular dermal matrix

Below shows the area of significant palpability/rippling under her breast.

implant exchange with internal bra and use of allograft

Her current implants are removed so they can be replaced with new implants.

implant exchange with internal bra and use of acellular dermal matrix

A sizer is used on the right breast to help Dr. Pousti determine which implant size would be the most beneficial in achieving the patients goals.

sizer for implant exchange with internal bra and use of acellular dermal matrix

AlloDerm, also known as ADM or is an acellular dermal matrix, derived from donated human skin tissue. Since AlloDerm is regarded as minimally processed and not significantly changed in structure from the natural material, the FDA has classified it as banked human tissue. AlloDerm is made from donated human skin. It is handled in much the same way as other transplantable organs. The tissue is processed to remove cells that might cause your body to reject the foreign tissue or react negatively to it. What’s left is the collagen structure (fiber-like proteins) and other proteins naturally found in skin. This structure acts as a frame for your tissue to grow into and around. This AlloDerm will help correct the palpability/rippling under the left breast.

allograft for implant exchange with internal bra and use of acellular dermal matrix

alloderm for implant exchange with internal bra and use of acellular dermal matrix

Below, the patient is immediately post surgery and has 1100cc (right) and 1050cc (left) XL saline overfilled breast implants.

after implant exchange with internal bra and use of acellular dermal matrix

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Posted in AlloDerm, Breast Asymmetry, Breast Pocket Correction, Breast Procedures, Breast Revision Surgery, Capsulorrhaphy (Internal Bra)


AlloDerm to Correct Skin Deformity

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This 42 year-old patient from Van Nuys , California wanted breast revisionary surgery. The patient previously had breast augmentation surgery, performed by another surgeon but the patient was unhappy with the scar tissue formation and wanted breast augmentation revision surgery. After many years of living with this issue, the patient decided to research for the best Board Certified Plastic and Reconstructive Surgeon in San Diego and found Dr. Pousti on the Internet. The patient reviewed many of Dr. Pousti’s before and after pictures and decided to meet with Dr. Pousti. Dr. Pousti met with the patient and after examination determined the patient had encapsulation present in the left breast. Encapsulation, also called capsular contracture occurs when an excessive amount of scar tissue forms around the breast implant creating a capsule resulting in hard and painful breasts. Dr. Pousti recommended the patient have an implant exchange and capsulectomy procedure performed. After breast augmentation with breast implants, excessive scar tissue may form around the breast implant which causes the breast implants to harden (similar to what a contracted muscle feels like). The cause of capsular contracture is not known but it is the most common complication with breast augmentation surgery. There are different grades of capsular contracture from mild to severe. The rate of capsular contracture has decreased from 20-30 years ago when all breast implants were placed above the muscle (sub-glandular). By placing the breast implants below the muscle (sub-muscular), the rate of capsular contracture has significantly decreased. Also, it is said the massage helps decrease the chance of capsular contracture. before breast augmentation with use of allograft

After the incision was made on the patient’s areola to remove her left breast implant there was purulent fluid (pus) present that needed to be removed. Due to the unexpected findings breast implant removal of both sides was performed. Dr. Pousti felt that it was best not to proceed with re-augmentation until she is completely healed and infection free. 7 months later, the patient returned with interest of having breast re-augmentation performed to achieve her goals.

side view before breast augmentation with use of allograft

At her consultation, Dr. Pousti recommended the use of Acelluar Dermal Matrix to prevent encapsulation from occurring again and also to correct the skin deformity that was occurring on the left breast.

markings for breast augmentation with use of allograft

The markings were performed prior to surgery and the procedure was discussed in detail between the doctor and the patient.

alloderm for breast augmentation with use of allograft

AlloDerm, also known as ADM or is an acellular dermal matrix, derived from donated human skin tissue. Since AlloDerm is regarded as minimally processed and not significantly changed in structure from the natural material, the FDA has classified it as banked human tissue. AlloDerm is made from donated human skin. It is handled in much the same way as other transplantable organs. The tissue is processed to remove cells that might cause your body to reject the foreign tissue or react negatively to it. What’s left is the collagen structure (fiber-like proteins) and other proteins naturally found in skin. This structure acts as a frame for your tissue to grow into and around. Using this Acellular Dermal Matrix will help prevent the capsular contracture and correct the skin deformity.

breast augmentation with use of allograft

breast augmentation with use of alloderm

The patient is shown  weeks post surgery and very happy with her results.

after breast augmentation with use of allograft

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Posted in AlloDerm, Breast Asymmetry, Breast Procedures, Breast Revision Surgery



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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