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Breast Asymmetry Patients
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| This 27 year old patient had been very unhappy with the shape and size of her breasts. She felt that her breasts were “uneven”, empty on top and “droopy”. She wanted to regain the “perky” breasts she once had and fill them out more as well. She wanted cleavage! Her friend recommended that she visit Dr. Pousti because of his experience with difficult breast procedures. She saw that Dr. Pousti has lots of experience with breast lifting as well as augmentation surgery.


The patient had some concavity of the chest wall as well causing her breasts to not have the “look” she wanted. This concavity is sometimes referred to as “pectus” excavatum. In pectus excavatum, also known as funnel chest, the sternum (breastbone) is depressed relative to the rest of the chest wall. Breast implants can be used to camouflage mild to moderate pectus excavatum.

The markings on the breasts show the measurements that Dr. Pousti performs prior to surgery. The “x” mark indicates where the nipple/areola complex will be moved for better placement of the areola on the breasts. The breast lift will also give the patient the “perkier” look she wanted.

When performing the breast lift, both areola are reduced in size as well. On the left breast, the excess skin is also removed for improved symmetry.

Different sized silicone gel implants were used in each breast as well as different profiles. This was done to achieve the best look possible for the patient. As you can see below, immediately after both breasts were finished, the results are amazing. The central “blue” area is where the chest was most depressed and with the breast implants, this depression is camouflaged. It looks like the patient has deep cleavage. The patient is almost 2 months out of surgery and extremely happy with her results.

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Posted in Aerola Reduction, Breast Asymmetry, Breast Lift with Implants, Pectus Excavatum
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| This 22 year old patient from Oceanside, California was unhappy with the size and shape of her breast and had been interested in breast augmentation surgery for several years. After doing her research she came across Dr. Pousti’s website and was impressed with the amount of experience he had.


During her consultation it was explained to the patient that the dip in her chest was a condition commonly referred to as pectus excavatum. Pectus excavatum is when the sternum (breastbone) is depressed relative to the rest of the chest wall. Breast implants are commonly used for pectus excavatum patients to camouflage the indention. By positioning the correct size/shape of breast implants on the chest wall, the pectus excavatum is camouflaged nicely giving the patient’s breasts the appearance of “deep cleavage”.

Markings as well as the procedure are reviewed with the patient in detail prior to surgery.

The purple arrows indicate where the right breast pocket must be moved up in order to achieve symmetry when the breast implants are in.

To give this patient her desired look a 575cc Silicone implant was placed in the right breast and a 300cc silicone implant was placed in the left.

Immediately After Surgery

The patient is very happy with her initial results of surgery.
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Posted in Breast Asymmetry, Chest Wall Reconstruction, Pectus Excavatum
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| This 31-year old patient from Perris, California (Riverside County) was uncomfortable with her breast asymmetry and pectus excavatum. The patient researched many different surgeons who were qualified to perform her breast augmentation surgery. However, the patient wanted a surgeon who was experienced in pectus excavatum and is also Board Certified in Plastic and Reconstructive Surgery.


Her friend, who was a previous patient of Dr. Pousti, referred her. During her consultation, the patient and her husband was able to seeing many before and after pictures of patients who has pectus excavatum and how Dr. Pousti had help them with breast augmentation surgery. The patient and her husband was convinced that Dr. Pousti was the best surgeon for her and after a few consultations, she decided to proceed with surgery.


Dr. Pousti demonstrates the severity of the patient’s pectus excavatum, her right breast is more prominent, while underneath the left breast the chest cavity look a bit more concaved.

Dr. Pousti uses different size implants and carefully creating the breast pockets in order to achieve a more symmetric and desirable look.

Saline breast implants were used; because the left breast was more prominent then right breast, 400cc was filled in the left breast and 500cc was filled in the right breast for symmetry. The patient is now 4-weeks post-op surgery and is very happy with her results so far. The patient continues to heal and will settle over time.
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Posted in Breast Asymmetry, Pectus Excavatum
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| This 27-year old patient was interested in breast augmentation surgery for several years. The patient has a congenital condition called Pectus Excavatum and she had heard, with breast augmentation surgery, when performed properly can hide the appearance of her Pectus Excavatum and create a deep cleavage appearance.



The patient is asymmetric from her chest concavity, with 550cc in the right breast and 575cc in the left breast, desirable cleavage was created. The “sunken-in” look before is now replaced with fullness and is symmetric looking on top. The patient is now 1-year post-op surgery and is very pleased with her results.
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Posted in Breast Asymmetry, Pectus Excavatum
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| This 32-year old patient from Alabama is post pectus excavatum repair surgery in 1999, due to the results of her surgery (severe asymmetry), the patient was extremely unhappy with the appearance of her breasts.

Pectus excavatum: A common congenital deformity, also known as funnel chest. The sternum (breastbone) is depressed relative to the rest of the chest wall. Breast implants can be used to camouflage mild to moderate pectus excavatum.

The patient researched for an experienced surgeon who is Board Certified in Plastic and Reconstructive Surgery and found Dr. Pousti on the Internet. The patient is now 2-1/2 weeks post-op breast augmentation surgery with moderate plus profile silicone-gel breast implants, 275cc in the left breast and 375cc in the right breast in order to achieve as much symmetry as possible. The patient is extremely pleased with the results of her surgery.
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Posted in Breast Asymmetry, Pectus Excavatum
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| This 22 year old from San Diego, California was interested in a breast augmentation for several years. After childbirth, she felt her breasts had lost fullness and wanted to regain volume. She began researching the internet for experienced plastic surgeons near San Diego and found double board certified surgeon, Dr. Tom Pousti. The patient was very impressed with Dr. Pousti’s credentials and skill with cosmetic surgery. She saw hundreds of “before” and “after” breast enlargement pictures displayed throughout his website and read many testimonials.

The patient met with Dr. Pousti and it was determined that she was a great candidate for breast enhancement surgery. She met with Dr. Pousti several times over the course of a year until she felt comfortable and ready to proceed with her breast augmentation.

The patient met with Dr. Pousti to perform markings and to discuss size and shape of her breasts post-surgery. The patient hoped to achieve a large and round, full look. She wanted to place an emphasis on her cleavage with a lot of fullness on the top of her breasts.

Dr. Pousti used moderate plus profile saline implants filled to 850cc on the right and 890cc on the left. The patient had mild asymmetry present prior to surgery, so her left implant is slightly larger than the right.

Before Breast Augmentation / After Breast Augmentation

The patient is now 1 week post-op and is very happy with her results!
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Posted in Breast Asymmetry, Breast Augmentation, Petite Frame Breast Augmentation, Saline Implants
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| 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
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| This 24 year old patient from Livermore, California had been interested in revisionary breast surgery after she was left with unsatisfactory results from her previous surgeon. After doing further research she came across board certified plastic surgeon Dr. Pousti and was impressed with his experience with breast revision surgery and decided that it was worth the travel to have him perform her surgery.

The patient was also interested in extra large implants and was having difficulty finding surgeons willing to go over 800ccs.

Prior to her surgery the patient and Dr. Pousti meet several times to discuss revisionary options and the breast procedure in detail. The last appointment before surgery measurements of the patient’s breasts are taken and markings are made. The markings are rechecked again in the operating room and adjustments are done if needed.

For the first step of the revisionary breast surgery the patient’s previous breast implants are removed.

Once the implants are removed Dr. Pousti revises the breasts pockets for the new implants. The patient had expressed that she was unhappy with the appearance of her breasts while she was lying down. To fix this Dr. Pousti used internal sutures to prevent the implants from falling to the sides. Sizers are then used to determine the size of implant needed to meet the patient’s size goals.
Before/After Implant Exchange with Overfilled Implants and Pocket Revision

800cc Saline implants overfilled to 1530ccs were used in this patient and she is extremely happy with the initial results of her surgery.

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Posted in Breast Asymmetry, Breast Augmentation, Breast Revision Surgery, Overfilled Saline Breast Implants, XL Breast Augmentation
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| This 40 year old patient from San Diego, California was interested in a breast reduction after loosing 30 lbs. After weight loss, she felt that she was ready to reduce the size of her breasts and make them ‘perkier’ as well.

The patient also had significant back and shoulder pain often associated with larger breasts. She had been considering the surgery for over 10 years and was referred to Dr. Pousti by her primary care physician.

During her consultation, Dr. Pousti reviewed possible options with the patient and discussed the benefits of breast reduction surgery. After discussing the surgery, the patient felt comfortable with choosing Dr. Pousti as her surgeon. She came into the office the night before surgery to meet with Dr. Pousti to perform markings.

During markings, Dr. Pousti is able to show the patient where incisions will be and where the new nipple/areola complex will be located post-surgery.

The patient’s surgery involves not only reducing the breasts size but also reshaping the breast tissue to give her that ‘perky’ look she desired.

After the patient’s tissue has been reduced and rearranged on one breast, Dr. Pousti shows the dramatic difference between the two breasts. The areolas are temporarily stapled to ensure symmetry is achieve prior to final closure of the incisions.

Before, when the patient was lying flat her breasts were so large and heavy they would fall to the side.

The patient’s breasts are now much smaller and wont cause the patient back, neck, and shoulder pain. The breasts also appear “perkier” than before giving them a much more youthful appearance.

The patient is extremely satisfied with her breast reduction results.
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Posted in Breast Asymmetry, Breast Lift, Breast Reduction, Post-Weight Loss
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| This 40 year old patient from El Cajon, California (San Diego County) had been interested in breast surgery for several years and after doing research online, came across Dr. Pousti’s website. She was very impressed with Dr. Pousti’s experience and credentials.

During the patient’s consultation she discussed with Dr. Pousti the fact that she was unhappy with breast asymmetry and wanted more of a ‘perky’ look. She felt her breasts were a bit droopy and empty.

In order to give the patient more fullness on top Dr. Pousti recommended a limited lift, also known as a benelli lift, and breast implants. This type of lift is generally suggested to patient’s that have smaller amount of lifting needed. The entire breast augmentation/mastopexy procedure was reviewed with the patient in detail prior to the surgery. Measurements of the patient’s breasts were taken and markings were done.

These markings are re-checked the morning of surgery and are used to ensure that breast symmetry is achieved.

During the benelli lift a doughnut shaped incision is made around the areola and excess tissue is removed. After the mastopexy portion of the procedure is performed sizers are set in place to determine the size of the implant need to meet the patient’s desired goals.

In this patient’s case 2 different sized implants had to be used in order to obtain symmetry. A 492cc Silicone Gel implant was used in the patient’s left breast, which was larger than the right pre-operatively, and a 533cc Silicone Gel Implant was used in her right breast.
Immediately After Breast Augmentation/Mastopexy

This patient is very happy with the results of her breast augmentation/mastopexy surgery.
Before/After Side View

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Posted in Benelli Lift, Breast Asymmetry, Breast Lift with Implants, Limited Lift (Benelli Lift)
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