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XL Breast Augmentation Patients

Capsulorrhaphy to Support XL Breast Implants

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This 44year old female from Overton, Nevada drove in to San Diego to have her breast revision surgery performed by double board certified plastic surgeon, Dr. Pousti. She desired more top and outer fullness in her breasts than she received from her previous breast augmentation 12 years ago. She began her research on www.realself.com when looking for a surgeon to help her achieve her goals.

before implant exchange with capsulorrhaphy

She communicated with Dr. Pousti via email and Dr. Pousti determined she would be a great candidate for implant exchange with XL saline breast implants. He also recommended performing capsulorrhaphy (internal bra) to help improve the breast implant pocket. She currently;y had medial breast implant malposition. 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.

side view before implant exchange with capsulorrhaphy

The patient sent over photos of her goals. This allowed Dr. Pousti to understand what the patient desired to achieve.

goals for implant exchange with capsulorrhaphy

She scheduled her surgery. Dr. Pousti performed the markings on the patient the morning of surgery prior to going into the operating room. The patient and Dr. discuss her goals one final time before proceeding.

markings for implant exchange with capsulorrhaphy

The red shaded area is where the capsulorrhaphy will be performed in order to close of the breast pocket and prevent symmastia.

implant exchange with capsulorrhaphy

The patient is shown immediately post surgery and has bilateral 1200cc XL saline overfilled breast implants.

after implant exchange with capsulorrhaphy

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Posted in Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Overfilled Saline Breast Implants, XL Breast Augmentation


Adding More Volume to Current Breast Implants

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This 34 year old female from Phoenix, Arizona desired to continue to enlarge her breasts with XL saline over filled breast implants. She was previously referred to Dr. Pousti and continued to come back for her procedures because she was very pleased with her results every time and knew he was the doctor to help her achieve her goals.before adding more cc's to current overfilled saline breast implants

The patient followed up with Dr. Pousti post her previous breast augmentations and when the time was right, flew back in for her breast revision procedure. Dr. Pousti and the patient discussed adding more cc’s to her current breast implants and performing capsulorrhaphy as well to provide additional support to the breast implants. 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 and provide support.

side view before adding more cc's to current overfilled saline breast implants

The patient is shown below immediately before and after her breast surgery. She has bilateral 1630cc XL overfilled saline breast implants.

adding more cc's to current overfilled saline breast implants

The patient was seen one day post her procedure and went back home after determining there were no complications. She will continue to follow up via email communication.

after adding more cc's to current overfilled saline breast implants

side view after adding more cc's to current overfilled saline breast implants

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Posted in Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Overfilled Saline Breast Implants, XL Breast Augmentation


Revision Breast Surgery with XL Breast Implants

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This 61 year old healthy female from North Hollywood, California was post previous breast augmentation-mastopexy surgery. Although she liked her breasts, she desired to enlarge her breasts with revisionary surgery. She wanted to exchange her current implants with XL saline overfilled breast implants to achieve a more round and full appearance.before implant exchange for XL saline breast implants and internal bra

She did a lot of research on the internet while looking for a skileld surgeon who could help her achieveher goals of XL implants. She noticed that Dr. Pousti had both the credentials and experience she was looking for. At her consultation, Dr. Pousti recommended removing her current implants and replacing them with XL saline implants, revising her breast lift, and performing capsulorrhaphy (internal bra) for addition support.

side view before implant exchange for XL saline breast implants and internal bra

The markings are performed prior to proceeding to the operating room.

markings for implant exchange for XL saline breast implants and internal bra

Her previous implants are removed so her breasts can be re-augmented.

implant exchange for XL saline breast implants and internal bra

Intra-operative sizers are used to aid Dr. Pousti in determining the best size implant for the patient.

sizers for implant exchange for XL saline breast implants and internal bra

The patient is shown below immediately post surgery and has bilateral 1200cc XL saline overfilled breast implants.

after implant exchange for XL saline breast implants and internal bra

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Posted in Breast Procedures, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Implant Exchange, Overfilled Saline Breast Implants, XL Breast Augmentation


XL Saline Implants with Internal Bra

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This 51 year old patient from Gold Canyon, Arizona was status post previous breast augmentation surgery performed by another surgeon. She felt that her implants were displacing and decided to research online for a doctor who could help her achieve her goals of much larger and more perky breasts. She began communicating with Dr. Pousti through emails and discussed her goals with him to determine if he could assist her.before implant exchange XL breast augmentation and internal bra

Dr. Pousti, who is a double board certified plastic surgeon specializing in breast revision surgery, recommended that the patient undergo revisionary breast surgery. His plan would be to remove her current implants and perform capsulorrhaphy (internal bra). 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. He would then use a sizer to determine how large he could safely go for the patient to achieve her goals. The risks and possible complications were also discussed.

side view before implant exchange XL breast augmentation and internal bra

The patient was able to express her goals through visual aids and goal photos (as shown below).

goals for implant exchange XL breast augmentation and internal bra

The markings are performed before going into the operating room. The patient and Dr. Pousti discuss for the last time what the patient desires to achieve from this surgical procedure.

markings for implant exchange XL breast augmentation and internal bra

Both previous implants are removed so the breasts can be re-augmented.

implant exchange XL breast enhancement and internal bra

An intra-operative sizer is used to assist Dr. Pousti in determining the best size implants for the patient to reach as close to her goals as possible.

implant exchange XL breast augmentation and internal bra

Below, the patient is shown immediately post surgery. She has bilateral 1000cc XL Saline Overfilled breast implants.

after implant exchange XL breast augmentation and internal bra

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Posted in Breast Procedures, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Overfilled Saline Breast Implants, XL Breast Augmentation


Overfilled XL Breast Implants

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This 33 year old female from Trabuco Canyon, California was status post previous breast augmentation and revision breast surgery and desired to further increase her breast size. The patient has a large athletic build and desired to add volume to her breast implants to achieve more fullness and cleavage.

before adding cc's to current implants

She was familiar with double board certified surgeon Dr. Pousti because of her previous experience with breast augmentation surgery. She was always very pleased with her surgical results and knew that returning to Dr. Pousti would be the right choice. She met with Dr. Pousti and he determined she would be a good candidate for XL saline overfilled breast implants. The patient proceeded with surgery. The markings were performed on the morning of surgery.

side view before adding cc's to current implants

The patient is shown immediately post surgery and has bilateral 2580cc Saline Overfilled breast implants.

after adding cc's to current implants

right view after adding cc's to current implants

adding cc's to current implants

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Posted in Breast Procedures, Breast Revision Surgery, Overfilled Saline Breast Implants, XL Breast Augmentation


XL Breast Implants and Tummy Tuck

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This 48 year old patient from North Richland Hills, California desired to remove excess skin she had on her abdomen through a tummy tuck while achieving larger breasts through breast revision. Although she was happy with the shape of her breasts, she wanted the size to be much larger.Pre-Tummy Tuck and Breast Revision- adding more cc's to current implants

She was familiar with Dr. Pousti due to previous surgery she had performed by him that she was very happy with. She came in for a consultation and Dr. Pousti determined she would be a good candidate for the procedure she was interested in.

Side view before Tummy Tuck and Breast Revision- adding more cc's to current implants

The markings were performed and the measurements for the abdominoplasty surgery were performed.

Markings for Tummy Tuck and Breast Revision- adding more cc's to current implants

Before Tummy Tuck and Breast Revision- adding more cc's to current implants

The muscle is repaired by bringing together the abdominal wall with sutures.

Before muscle repair for Tummy Tuck and Breast Revision- adding more cc's to current implants

Below, the patient is shown immediately post muscle repair.

After muscle repair for Tummy Tuck and Breast Revision- adding more cc's to current implants

The excess skin is removed from the abdomen to help the patient achieve her goals.

Removal of excess skin for Tummy Tuck and Breast Revision- adding more cc's to current implants

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Posted in Abdominoplasty, Body Contouring, Breast Procedures, Breast Revision Surgery, Overfilled Saline Breast Implants, XL Breast Augmentation


Revisionary Breast Surgery

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This 38 year old patient from London flew in to have her breast revision surgery performed by double board certified Dr. Pousti.Before breast revision with internal bra

The patient was very unhappy with her breasts after multiple procedures performed by another surgeon. After researching online for the best plastic surgeon to handle her circumstance, she contacted Dr. Pousti. During her email consultation, Dr. Pousti told her that he would be able to improve her situation but that he can not promise “perfection”.  She understood and stated that she had realistic expectations.

Side view before breast revision with internal bra

She had her consultation the day prior to surgery and the markings were performed the following morning. Her current implants were removed and replaced with new saline breast implants. An internal bra was used to help give her implants more support.

breast revision with internal bra

Below, the patient is shown before and after breast revision surgery sitting up and laying down. She has bilateral 1340cc (right) overfilled saline breast implants.

After breast revision with internal bra

Laying down after breast revision with internal bra

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Posted in Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Implant Exchange, Overfilled Saline Breast Implants, XL Breast Augmentation


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


XL Breast Implants with Overfilled Saline Implants

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This 29 year old female from San Diego, California was interested in enlarging her breasts to achieve more fullness, cleavage, and roundness. She desired breast revision surgery in order to help her achieve her goals. She had previously had surgery performed by another surgeon and was very unhappy with her outcome. She was seen by Dr. Pousti previously with goals of having overfilled XL saline breast implants. Due to the size she desired, Dr. Pousti was not able to complete it in one stage.before 2nd stage breast enlargement
She was familiar with the incredible quality of work performed by double board certified Dr. Pousti due to her previous surgery and knew coming back to him for an enlargement would help her achieve her goals.

side view before 2nd stage breast enlargement

The morning of surgery, Dr. Pousti examines the patient one more time and measures things out to prepare for the surgery.  Markings are made and gone over with the patient in detail.

2nd stage breast enlargement

Below, she is immediately post surgery and has bilateral 2330cc XL saline overfilled breast implants.

after 2nd stage breast enlargement

side view after 2nd stage breast enlargement

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Posted in 2 Stage Procedure, Breast Procedures, Overfilled Saline Breast Implants, XL Breast Augmentation


Breast Revision With Use of AlloDerm for Rippling

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This 28 year old patient from Oceanside, California, desired to correct the rippling she was experiencing caused from her saline breast implants from a previous surgery (performed by another surgeon). She desired larger and more full breasts. Her goal was to achieve more roundness.before saline overfilled breast enhancement with use of allograft

She was referred to Dr. Pousti through two good friends of hers who were satisfied patients. While doing her own research, she decided to schedule a consultation due to Dr. Pousti’s double board certification and skill in breast revision surgery.

side view before saline overfilled breast enhancement with use of allograft

The markings for the surgery were performed prior to the procedure. The red lines represent where the rippling is present, and therefore where Dr. Pousti recommends the use of Acellular Dermal Matrix.

markings for saline overfilled breast enhancement with use of allograft

Her current implants are removed and a sizer is used to help Dr. Pousti determine the best size implant to help the patient achieve her goals.

sizer for saline overfilled breast enhancement 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.

acellular dermal matrix for saline overfilled breast enhancement with use of allograft

For this patient, the AlloDerm will help prevent the rippling that was occurring in her breasts by adding another layer between her skin and the implants.

saline overfilled breast enhancement with use of allograft

The patient has 1200cc (right) and 1150cc (left) XL saline overfilled breast implants.

after saline overfilled breast enhancement with use of allograft

side view after saline overfilled breast enhancement with use of allograft

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Posted in AlloDerm, Breast Procedures, Breast Revision Surgery, Implant Exchange, Overfilled Saline Breast Implants, XL Breast Augmentation



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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