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Breast Asymmetry Patients

Correction of Chest Wall Asymmetry

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This 41 year old patient from California was interested in breast augmentation surgery in order to achieve more full breasts. She also desired to camouflage her chest wall asymmetry that she has had her whole life. This condition is called 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.  Sometimes also referred to as asymmetric breast hypoplasia.

Before breast augmentation with pectus excavatum-chest wall asymmetry

Dr. Pousti has considerable experience with using breast implants to improve the appearance of the chest wall for patients with pectus excavatum. While researching, this patient felt confident in utilizing Dr. Pousti’s board certification and skill in breast augmentation to help her achieve her goal of larger breasts with less attention drawn to her chest asymmetry.

side view before breast augmentation with pectus excavatum-chest wall asymmetry

She came in for her consultation and was able to view hundreds of before and after photos in addition to meeting with Dr. Pousti.

angled view before breast augmentation with pectus excavatum-chest wall asymmetry

In the above photos as well as below, the chest wall asymmetry is demonstrated and indention is demonstrated.

breast augmentation with pectus excavatum-chest wall asymmetry

The patient is immediately post surgery and has 380cc (right) and 350cc (left) silicone gel breast implants.  Differential breast implant sizes are used to improve the breast asymmetry.

after breast augmentation with pectus excavatum-chest wall asymmetry

side view after breast augmentation with pectus excavatum-chest wall asymmetry

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Posted in Breast Asymmetry, Breast Procedures, Pectus Excavatum


Breast Lift with Implants

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This 24 year old patient from North Hills California was interested in breast augmentation surgery to achieve larger breasts with more fullness and cleavage.  She wanted to address her breast asymmetry as well.before mastopexy

While searching for the best plastic surgeon who was board certified to perform her surgery, she found Dr. Pousti.

side view before mastopexy

At her consultation, Dr. Pousti recommended also adding a breast lift with the augmentation. This would help the patient achieve the fullness she desired by raising her areolas and removing excess skin. The patient proceeded with surgery. Below, the sizer is used during the surgery to help Dr. Pousti best reach symmetry as well as the patients goals.

breast mastopexy

The patient is immediately post surgery and has 434cc (right) and 465cc (left) silicone gel implants. The difference in implant sizes helps the patient reach better breast symmetry.

after breast mastopexy

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


Breast Asymmetry

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This 30 year old patient from Alaska had been interested in breast surgery for quite some time.  She not only wanted larger, more “perky” breasts but she wanted to address her breast asymmetry as well.  She decided to fly to San Diego to have her breast augmentation and breast lift procedure performed by Dr. Pousti because of his expertise with breast surgery procedures.before breast augmentation with lift

She was referred to Dr. Pousti from a satisfied previous patient. At her consultation, she met with Dr. Pousti and learned more about the procedure she was interested in, as well as viewing hundreds of before and after pictures of Dr. Pousti’s work. She felt confident in his double board certification and scheduled her surgery.

side view before breast augmentation with lift

Dr. Pousti discussed her breast asymmetry and determined that he would need to perform a benelli breast lift (incision around the areola) on her right side but a more extensive breast lift on her left side to achieve as much symmetry as possible.  The patient understood that perfect. Her markings were performed the night before surgery and were reviewed and discussed again the following morning.

markings for breast augmentation with lift

The “x” below represents where the areola is planned on being after surgery.

breast augmentation with lift markings

Below, the patient is in the midst of the breast lifting procedure. Her right breast only needed a stage one breast lift while her left breast needed a stage two breast lift.

breast augmentation with lift

The patient has bilateral 545cc high profile silicone gel implants.

breast augmentation with lift after

after breast augmentation with lift

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Posted in Areola/Nipple Procedures, Benelli Lift, Breast Asymmetry, Uncategorized


Revision Breast Augmentation with Capsulectomy and Internal Bra

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This 29 year old patient from Honolulu, Hawaii, flew in to have breast augmentation revision surgery performed by Dr. Pousti. She was unhappy with the results of a surgery previously performed by another surgeon. She desired to achieve her fullness and better shaped breasts.Before implant exchange with capsulectomy and capsulorrhaphy

She found Dr. Pousti while looking for the best plastic surgeon who specialized in breast revision surgery and had obtained a board certification.

Side view before implant exchange with capsulectomy and capsulorrhaphy

After communication via e-mail with Dr. Pousti, the patient decided to schedule surgery. Her pre-op visit was performed the day before surgery and the markings were completed the following morning. The surgery was discussed in details.  She had scar tissue that needed to be released on her left side.

Markings for implant exchange with capsulectomy and capsulorrhaphy

The implants were removed to prepare the breast for replacement and re-augmentation.

implant exchange with capsulectomy and capsulorrhaphy

Below, the patient is immediately post surgery and has bilateral 395cc silicone gel high profile implants.  The “red” line indicates where the scar tissue was released to help improve the breast shape and feel.

after implant exchange with capsulectomy and capsulorrhaphy

side view after implant exchange with capsulectomy and capsulorrhaphy

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Posted in Breast Asymmetry, Breast Procedures, Breast Revision Surgery, Capsular Contracture, Capsulorrhaphy (Internal Bra), Implant Exchange


Breast AugmentationRevision with Internal Bra

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This 29 year-old patient from Los Angeles, California was interested in breast revision surgery.  She previously had breast augmentation surgery in 2003 and breast revisionary surgery in 2008 (both preformed by another surgeon). She was unhappy with her results due to breast asymmetry, size and bottoming out of one side.

implant displacement

She had done a lot of research on who was the best plastic surgeon for revisionary breast augmentation surgery in Southern California and found Dr. Pousti. After seeing the results that Dr. Pousti had achieved for other patients in the same situation, this patient decided to proceed with revisionary breast augmentation surgery.  After meeting with Dr. Pousti, her breast augmentation revision was discussed.  Internal sutures (Capsulorrhaphy) would be used to improve the placement of the breast implants and the breast asymmetry.

implant exchange

Markings were carefully drawn out in detail, the morning of surgery. The arrows show the fullness that the patient wants to achieve.

capsulorrhaphy

Capsulorrhaphy (internal sutures) will be preformed to help with breast implant inferior and lateral displacement (see how the implant falls off to the side when the patient is laying down?)

internal bra breast revision

Before and immediately after breast revisionary surgery

breast revision

immediately after breast revision (side view)

breast revision with internal sutures

The patient’s old implants were removed and 800cc silicone gel implants were used to achieve the patient’s desired look.

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Posted in Breast Asymmetry, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Implant Exchange


Breast Revision with Internal Sutures

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This 42 year-old patient from Escondido, California was interested in breast augmentation revision surgery.  She previously had breast augmentation surgery (preformed by another surgeon) but was unhappy with the size, shape, and breast asymmetry.

implant displacement breast revision

She was referred to Dr. Pousti by a friend, after reviewing testimonials of patients who had revisionary breast surgery,  she felt comfortable with him as her surgeon.

breast reivisionary surgery

She needed capsulorrhaphy (internal bra) for better placement of her breast implants on her chest wall.  This would also give her the upper fullness she was wanting.

breast revision

Markings are made prior to surgery and are used as a guidelines for surgery as well as for patient education.

breast revisionary surgery

Below you can see that when the patient is laying down, the breast implants fall to the side so capsulorrhaphy “internal sutures” needed to be performed laterally in addition to inferiorly on the right side.

internal sutures

Immediately after the old implants are removed and capsulorrhaphy was preformed

lateral displacement

Temporary sizers are put in place and the patient is “sat up” on the operating room table so that Dr. Pousti can make adjustments in the breast implant size and pocket symmetry to achieve the patient’s goals.  This “sitting up” of the patient and pocket adjustments are performed at least 3-5 times through out the surgery.

implant exchange

before and immediately after breast revisionary surgery

implant exchange breast revision

595cc silicone gel implants were used along with internal sutures (capsulorrhaphy) to achieve the patients desired look.

A bolster dressing will be placed to give support to the areas where capsulorrhaphy was performed.   This will be in place for about one month.  Implants may take 3-6 months (sometimes longer) to settle to see the final result.

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Posted in Breast Asymmetry, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Implant Exchange


Breast Augmentation and Lifting Surgery

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This 29 year-old patient from San Diego, California had been interested in breast augmentation surgery for many years.  She was unhappy with the size, shape and breast asymmetry present.  She wanted her breasts to be “more perky” and more symmetrical.  breast augmentation with lift

She researched online and found Dr. Pousti. After looking at his before and after work, she decided to have a consultation with him to get more specific information about her case.  After examining this patient, Dr. Pousti informed her that to achieve the look she was wanting, breast lifting surgery would need to be performed as well as breast implants placed.

After reviewing the potential risks and complications associated with this type of surgery, the patient decided to proceed with surgery.

breast lift with implants

Dr. Pousti met with the patient again the morning of surgery to go over the “markings” and discuss the procedure one more time with the patient.

breast lift & augmentation

augmentation with lift

Before and immediately after breast augmentation and breast lifting surgery

mastopexy with implants

augmentation with mastopexy

545cc silicone-gel implants were used to achieve the patient’s desired look.  The incision lines will take up to one year to fully mature, fade and flatten down.  The breast implants will take months to settle into the pockets.

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


XL Breast Implants with Correction of Bottoming Out

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This 37 year-old patient from Carlsbad, California was interested in breast augmentation revision surgery. She previously had breast augmentation surgery (preformed by another surgeon) but was unhappy with the breast asymmetry and the “bottoming out” of her right side.  She wanted her breasts fuller, rounder, and significantly larger in size. She was referred to Dr. Pousti by a friend and met with him for a consultation and knew right away that he was the best plastic surgeon for her.

Before breast revision with internal bra

Dr. Pousti has significant experience in breast augmentation revision surgery as well as XL breast implants and knew what  needed to be done to achieve the patient’s goals.  It was decided that capsulorrhaphy (internal bra) would be performed with permanent sutures for better breast implant placement on the chest wall.

Side view before breast revision with internal bra

Markings ware made and used as guidelines during surgery.

Markings fro breast revision with internal bra

The arrows indicate where the patient wants more fullness.

breast revision with internal bra

Immediately after implant removal.

breast implant revision

The old saline implants were removed.

breast revision-implant exchange

Below is before and immediately after XL breast revisionary surgery with capsulorrhaphy.

After breast revision with internal bra

Side view after breast revision with internal bra

Saline implants were filled to 1,270cc to achieve the patient’s desired look.

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Posted in Bottoming Out, Breast Asymmetry, Breast Pocket Correction, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Implant Exchange, Overfilled Saline Breast Implants


Breast Revision after Encapsulation & Deflation

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This 31 year-old patient from La Mesa, California wanted to have breast revisionary surgery. The patient previously had breast augmentation surgery in 2007, performed by another surgeon. Due to encapsulation (scar tissue) of her left breast and recent deflation of her right breast, the patient wanted to proceed with breast augmentation revision surgery. implant deflation and encapsulation

The patient decided to research 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.  During her consultation, the patient was able to speak with patients who also had revisionary breast surgery with Dr. Pousti. Impressed by Dr. Pousti’s experience, the patient scheduled her surgery.

breast revision, implant exchange

Markings were carefully drawn out, notice that the left breast is 1.5cm lower than the right breast and so a limited breast lift will be performed on that side. Capsulectomy (removal of  the capsule formed around the implant) will also be preformed on the left breast and both current implants will be removed.

breast revision-deflation,encapsulation

In the operating room, Dr. Pousti takes his time to achieve the best results. With sizers in place, adjustments are made in implant size and pocket position to achieve the best results possible.

breast revision, encapsulation, deflation

before and immediately after breast revisionary surgery

breast revision

breast revision-implant exchange

495cc silicone gel breast implant was used for the right side and 465cc was used for the left side to achieve the patient’s desired look and breast symmetry.

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Posted in Breast Asymmetry, Breast Revision Surgery, Implant Exchange, Limited Lift (Benelli Lift), implant deflation


Tuberous Breast Correction

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This 25 year-old patient from Oceanside, California was interested in breast augmentation surgery for several years.  Unhappy with her “tubular breasts” and breast asymmetry she wanted to have surgery to correct it. Tuberous Breasts have a very narrow base and usually a long skin envelope. In the most severe cases of Tuberous Breast, a breast lift can be done through an incision around the areola, making the breast into a more rounded shape that the patient will be happy with. tuberous breast augmentation

She researched for Board Certified Plastic Surgeon herself, and came across Dr. Pousti on the Internet, and after look through many before and after pictures of patients he has help with the same case the patient knew Dr. pousti would be the best surgeon for her.

During her consultation, Dr. Pousti and the patient discussed improving symmetry and shape to  achieve her desired look, a limited breast lift would be needed for both breasts.  To perform a benelli lift, Dr. Pousti would place the incision around the areola (with time, this incision heals beautifully and is barely visible)

breast augmentation and correction of tuberous breast

Markings are made prior to surgery and used as guidelines- the “x” indicates where the new nipple/areola complex will be after the breast lift procedure.

breast augmentation with lift

Before and Immediately After correction of tuberous breast surgery– different sized implants were used to address the breast asymmetry.

breast augmentation with limited lift

breast lift with implants

720cc of saline was used in right breast and 690cc of saline was used in the left breast to achieve the patient’s desired look and breast symmetry

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



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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