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San Diego Cosmetic Plastic Surgery

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Breast Asymmetry Patients

Staged Breast Revision Surgery with Strattice

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This 23 year old patient from New York made a trip into San Diego to meet with Dr. Pousti.  She previously had breast augmentation surgery (not performed by Dr. Pousti) and was now unhappy with the shape and positioning of the breast implants.  She had bottoming out as well as breast asymmetry. She wanted the XL breast augmentation.

After meeting with Dr. Pousti, breast augmentation revision surgery was discussed and Dr. Pousti let the patient know that he would need to perform her surgery in 2 or 3 stages to achieve the size, shape and placement that the patient was wanting to achieve.

The patient decided to fly in and proceed with surgery – her first stage (nov. 2017)  involved removal of her breast implants, capsulorrhaphy, full mastopexy surgery to make a solid foundation for the future surgeries.

Above photo shows the patient in the operating room immediately after her breast implant removal / breast lift

Four months later (see above), the patients incisions have healed and she is anxious to proceed with the 2nd stage procedure – replacement of her breast implants.

The second stage procedure involved revision breast augmentation, the use of overfilled saline breast implants, as well as the use of acellular dermal matrix (also called ADM or Strattice)

Below photo shows the pieces of Strattice used in the lower poles of the breast pockets.

Below shows the patient immediately after breast augmentation with 1100cc overfilled saline breast implants.

Below is the progression of where the patient started and where she currently is today.

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Posted in 2 Stage Procedure, AlloDerm, Bottoming Out, Breast Asymmetry, Breast Lift, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Overfilled Saline Breast Implants, XL Breast Augmentation


Revision Breast Surgery

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This 25 year old was interested in revision breast surgery.  She was not happy with her breast size or her breast asymmetry.   

remove and replace

After researching for the best plastic surgeon to perform her revisionary breast surgery, she found Dr. Pousti.  She was looking for the very round, XL look and was very confident that Dr. Pousti would be able to achieve her goals.

revisionary surgery

After discussion of her goals, she and Dr. Pousti decided to remove her current breast implants and replace them with larger, saline overfilled breast implants.  Markings and measurements are performed prior to surgery.

revision

revisionary

revision surgery

Above shows the patient immediately after breast augmentation revision with 1200cc right breast and 1010cc left

 

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Posted in Breast Asymmetry, Breast Revision Surgery


Breast Asymmetry / Tuberous Breasts

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This 23 year old was interested in improving her breast asymmetry.  She had been thinking about breast surgery for many years and after lots of research found Dr. Pousti.  He had expertise in regards to tuberous breasts and breast surgery in general and that made the patient feel very confident in her choice.

lifting surgery

She and Dr. Pousti discussed her goals of improving the shape and size of the breasts as well as the symmetry. Dr. Pousti discussed performing the surgery in 1 stage or 2 stages – discussing all potential risks and complications related to the surgery.

breast lifing surgery

Markings and measurements were performed prior to surgery and the patients goals were discussed again in detail.  Dr. Pousti determined that it would be in the patient’s best interest to perform her surgery in stages.  2- Staged Procedure = The first surgery would be to perform the breast lift portion and have a solid foundation in place for the 2nd surgery – the Breast Augmentation Portion.

lift

The patient trusted her surgeon and proceeded with the mastopexy procedure to improve her breast symmetry and shape.

mastopexy

See the photos showing immediately after breast lifting surgery and the beautiful change in shape and symmetry.

breats surgery

lift no implants

bilateral mastopexy

 

Patient’s Experience:

This may get wordy, but please bear with me because my experience has been more than 20 years in the making. Ever since I hit puberty I’ve known that some day I would have my breasts corrected; I always knew they weren’t “normal”–and I don’t mean that in a societal beauty way, I mean that in a very broad sense. I wasn’t able to put a name to it until I was an adult, but I did eventually learn that I have tuberous breasts. Not only has this condition caused me much embarrassment and shame throughout my life but it’s also made finding bras (any bras) and shirts a nightmare. Bras never fit but I eventually settled on buying the bras that have enough padding to increase my bust by 2 cup sizes even though I get stabbed by underwire constantly and they slide up because I have no lower breast pole. With my 35th birthday fast approaching and being fed up with being poked by underwire I decided that it was finally time to have this corrected. I generally accept and appreciate the body I’ve been given but I’ve just never been able to make peace with my breasts. ‘They’ say to go to at least 3 consults before deciding on your surgeon. Dr. Pousti was consult #2 for me and I booked my surgery with him at my consult visit. Just like I *knew* Surgeon #1 wasn’t the right fit for me, I *knew* that Dr. Pousti WAS. My consult and pre-op appointments were thorough and any questions I had were answered honestly and appropriately. One of my biggest concerns was that given my anatomy, did he believe that I could reasonably achieve a look similar to my goal photos, or was I more likely to only be able to achieve my “NO!” photos. Dr. Pousti believed that I could achieve what I was hoping for and explained my options. The real magic happens on surgery day though, and I say that as someone who had to adjust her expectations after being gowned and marked. We had originally planned for a 1 stage operation to get the lift and implants done at the same time. While Dr. Pousti was making his many, many precise markings on me I felt like I could notice the mental gears turning a bit in his head, and I was right. Upon reviewing my “boob board” again with my desired outcomes and the outcomes I really didn’t want, Dr. Pousti was very up front with me and recommended that I do this in 2 stages. Even though he knew he’d be disappointing me and breaking my heart a little he 1,000% had my best interests at heart with regard to both safety and aesthetics. I trusted him and his expertise and tearfully agreed to do a 2 stage operation, which meant that I’d just be getting a lift right now and would have to come back in a few months to have the implants done. Even with all of these other great points I’ve enjoyed about Dr. Pousti (his staff, his honesty, his attention to detail, double board certification and so on), the simplest thing he did for me meant the most, I think. After getting me comfortably on the table in the OR this morning, Dr. Pousti himself held my hand and verbally comforted me at my side while anesthesia went to work putting me under. Don’t get me wrong, I LOVE nurses, but I’ve had quite a few surgeries and never once had a doctor do this! They’ve always left that to the nurses while they finished doing whatever they needed to. It was such a simple gesture, but I couldn’t believe it! Dr. Pousti has an amazing bedside manner to compliment his exceptional surgical skills. I’m only about 10 hours post-op right now but I am absolutely confident that I made the right choice in going with Dr. Pousti and I look forward to getting my second stage completed with him once I’m ready.

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Posted in Breast Asymmetry, Tuberous Breast Deformity


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

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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


Pectus Excavatum

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This 34 year old had been thinking about breast augmentation surgery to improve her breast size, breast asymmetry and also to camouflage her pectus excavatum.  She searched for the most experienced plastic surgeon to help her achieve her goals and found Dr. Pousti.

silicone implants

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.

augmentation

Markings and measurements are performed prior to surgery.  Dr. Pousti has indicated where the patient wants “fullness” (upper pole) and the “red x’s” indicate the area of chest wall depression.

breast augmentation

ba

Immediately after breast implant placement to camouflage pectus excavatum with high profile silicone gel breast implants –
300cc Left..350cc on the right

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Posted in Breast Asymmetry, Pectus Excavatum


Breast Augmentation for Breast Asymmetry

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This 31 year old from New York had been thinking about breast enhancement surgery for several years.

silicone gel implants

After examination and discussion of goals, it was determined that in addition to breast implants, a benelli breast lift would be necessary on the right breast to improve breast symmetry.

right side lift

breast surgery

Markings and measurements are performed prior to surgery.  The “smiley face” indicates the breast that is larger and lower.  Dr. Pousti will do his best to improve the breast asymmetry during surgery.

right sided mastopexy

breast procedure

Immediately after breast augmentation, benelli breast lift on right side and mentor 350cc implant on the right and 375cc implant on the left.

 

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Posted in Breast Asymmetry, Breast Augmentation, Breast Lift


Constricted Breast Correction with Benelli Breast Lift

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This 21 year old patient from Fontana California had been interested in breast surgery for many years. She wanted to increase her breast size but also wanted to improve the shape of her breasts (more round).  After extensive research trying to find the best plastic surgeon to help her with her breast surgery, she found Dr. Pousti

tuberous breasts

After examination and discussion of goals, Dr. Pousti determined that the patient would benefit from not only placement of breast implants but also an areolar breast lift to address the “breast constriction” and improve breast shape and position.  She also has some breast asymmetry that could be addressed during the surgery.

constricted breasts

Markings and measurements were performed  prior to surgery and the procedure was discussed in detail again with the patient.

breast procedure

mastopexy

Above shows the incision around the right areola and the skin that was removed for better symmetry.

breast surgery

correction of bilateral constricted breast

constricted breast

Immediately after breast surgery to address constricted breasts:
Mentor smooth round ultra high profile silicone gel breast implants – 400cc left side, 375cc right side.

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Posted in Benelli Lift, Breast Asymmetry, Limited Lift (Benelli Lift), Tuberous Breast Deformity


Breast Asymmetry

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This 22 year old from San Diego California had been interested in breast augmentation surgery for many years. She was interested in enhancing her breast size as well as addressing her breast asymmetry.

silicone gel implants

She met with Dr. Pousti and breast lifting as well as breast augmentation was discussed.  Her right breast is larger and lower than her left breast and so this would have to be taken into account during the surgery.

breast lift

breast surgery

Markings and measurements are performed prior to surgery and the procedure is discussed in detail once again.

 

breast procedure

breast augemntation mastopexy

lift

Immediately after Breast Augmentation with Mentor ultra high profile, silicone gel breast implants – 650cc on the left and 590cc on the right.  More breast lifting was performed on the right breast as well to achieve more symmetry between the 2 breasts.

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Posted in Breast Asymmetry


Breast Reduction with Auto Augmentation

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This 50 year old nurse from Riverside County had been interested in breast reduction surgery for over 3 years. Her sister was a patient of Dr. Pousti and referred her to our office.  She was having neck, back and shoulder pain due to the size of her breasts. The patient wanted to reduce her breast size and address her breast asymmetry.

breast reduction (3)

After meeting Dr. Pousti and discussing her concerns and goals, she felt very confident in his expertise regarding breast reduction surgery and proceeded to have surgery.

breast reduction (4)

Markings and measurements are performed prior to surgery and breast reduction / mastopexy surgery were discussed in detail with the patient.

breast reduction

breast reduction (2)

reduction

breast procedure

breast surgery

Above photos show the patient immediately after breast reduction surgery -Tissue removed from right side 220g – tissue removed from the left side 448g.

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Posted in Auto Augmentation, Breast Asymmetry, Breast Reduction



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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