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XL Breast Augmentation Patients

Revision Breast Augmentation with ADM to Address Rippling / Palpability

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This 45 year old patient from  San Antonio Texas was looking for the best revision breast surgery surgeon to help her with the breast implant revision that she needed and found Dr. Pousti on the real self website.  She had been thinking about this procedure for 2 years and was happy to start the process.

saline

She previously had breast implants placed (450cc saline implants) but was not pleased with the shape, size or the rippling.

implants

She wanted the XL breast implants as well as wanted to improve the rippling of the breast implant on the right side.

allograft

Dr. Pousti discussed the use of overfilled saline breast implants as well as Acellular Dermal Matrix (ADM) for additional coverage of the area of concern.

overfilled

The “arrows” in the above photo indicates where the patient wants more “fullness” after surgery.revision

Above shows the patient with her breast implant removed.

removal

The photo above shows the right breast with the temporary sizer in place showing the fullness on top.

replace

The ADM (Strattice) will be placed in the breast for additional coverage to help with the rippling issue.

capsulorraphy

breast procedure

implant exchange

The patient understands that the incision will heal and as it heals, it will flatten out.  Also, the patient understands that it takes months to see the final results of the surgery … she is very happy with the early results of her procedure.

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Posted in AlloDerm, Breast Pocket Correction, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Overfilled Saline Breast Implants


XL Breast Augmentation

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This 32 year old patient of Dr. P0usti previously had breast augmentation surgery and now wanted to increase her breast implant size to the XL breast size.

removal implant

After evaluation, it was determined that she was able to go larger in size and so she proceeded for surgery.

replacement of implants

implant exchange

breast procedure

silicone implants

Her silicone gel breast implants were replaced with 1000cc saline overfilled saline breast implants and the patient is pleased with the initial results of her surgery.

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Posted in Overfilled Saline Breast Implants, XL Breast Augmentation


Revision Breast Surgery with Internal Bra

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This 52 year old patient from San Bernardino County had been interested in Breast Augmentation Revision for  many years.  She researched to find the best breast revision surgeon for her procedure.   Her previous breast augmentation surgery was performed by a different surgeon but after doing her research, she decided to make the trip to San Diego to meet with Dr. Pousti.

capsulorraphy

She was interested in XL breast implants but also wanted to improve the position of her breast implants on her chest wall.  After examination, Dr. Pousti recommended the internal bra procedure as well as benelli breast lifting for better positioning.  The patient currently has 800cc breast implants and wants larger, overfilled saline breast implants.

revision breast surgery

Markings and measurements are performed prior to surgery and the procedure is discussed in detail once again with the patient.  The potential risks and complications of revisionary breast surgery and larger breast implant surgery are reviewed with the patient one last time.

overfilled saline breast implants

Below, the patient is on the operating room table ready for surgery.  The “red arrows” indicate where she was asking for more “fullness” and you can see measurements for the benelli breast lift as well.

internal bra

The patient’s silicone gel breast implants were removed – one of those implants had ruptured.

ruptured silicone gel implants

After removal of the ruptured silicone gel breast implants, the breast pocket is cleaned out before new breast implants are placed.

donut mastopexy

saline implants

Above shows the patient before and immediately after implant exchange with 1550 cc overfilled saline implants as well as capsulorrhaphy and benelli breast lifting.  She is very pleased with the outcome of her surgery.

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


XL Breast Augmentation Revision

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This 24 year old patient from Miami, Florida was interested in larger breast implants and after researching for the most experienced plastic surgeon who performs the XL Breast Implants and Breast Revisionary Surgery, she decided to travel from Miami to San Diego for her breast augmentation revision.

Breast Augmentation Revision

Because her current breast implants were in good position, she discussed the internal bra technique with Dr. Pousti but it was determined that this was not necessary in her case.
Saline Overfilled Breast Implants

After starting the process via email with Dr. Pousti, it was determined that she was a great candidate for saline overfilled breast implants to achieve her larger goals.

breast augmentation

breast revision surgery

overfill

The patient’s breast implants were removed and replaced with 800cc saline breast implants overfilled to 1300cc on the left breast and 1270cc on the right. The patient is extremely pleased with the early results of her procedure.

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


Revision Breast Surgery with Arm Lifting

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This 53 year old patient from Northern California had significant weight loss and was now looking for a well experienced plastic surgeon to perform her revision breast surgery as well as arm lifting surgery.  Her previous surgery was not performed by Dr. Pousti.

revision bilateral breast augmentation

She was not happy with the size, shape and positioning of her breast implants and also did not like the loose hanging skin of her upper arms after her weight loss.

revision

After evaluation, it was determined that Dr. Pousti would remove her current breast implants, perform capsulorrhaphy (internal bra) and replace with new saline overfilled breast implants to the XL size the patient was wanting as well as brachioplasty surgery.

overfilled saline filled implants

Above shows the patient with markings and measurements ready for her revision.

 

 

overfilled

Above photo shows one side with a temporary sizer in place for evaluation of breast implant size and shape.  Below shows both breasts being evaluated.

saline overfill

Below photos are in the operating room immediately after her surgery with saline breast implants that are overfilled to 1200cc.

bilateral breast capsulorraphy

bilaeral breast augmentation overfilled saline filled implants

Below photograph shows Dr. Pousti performing the markings and measurements of the arm area prior to the arm lifting surgery. It is very important to remove as much of the loose skin as possible but not to remove too much.

arm lift

bilateral arm liftAbove is the patient immediately after her arm lifting procedure.  She is very pleased with her early results and has returned home.  Will continue to keep in touch with our office via phone and email as she continues to recover.

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Posted in Arm Lift, Breast Pocket Correction, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Overfilled Saline Breast Implants, Post-Weight Loss


Overfilled Saline Breast Implants with Internal Bra

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This 51 year old from Arizona was interested in increasing her breast implant size.  She previously had breast augmentation surgery performed by another surgeon but wanted to increase the “fullness on top”.  She had been thinking about this type of breast augmentation revision surgery for over 3 years.

implant exchange

After research online, she found that Dr. Pousti had extensive experience with revisionary breast surgery and especially with the XL breast implants.  She started the communication with Dr. Pousti and his staff and arranged to have surgery.

implant exchange (2)

She did not like how her current breast implants would “fall out toward her armpits” when she laid down so the capsulorrhaphy procedure was discussed as well. Internal bra / Capsulorrhaphy are interchangeable.   The current capsule that has formed around her breast implants is used and a 2 layered, suture technique is performed to create a “new pocket” for the breast implant and limit the migration of the implant toward the patient’s armpit.

internal bra

This patients previous breast implants were replaced with Mentor 800cc saline breast implants and overfilled to 1300cc.  The patient is very pleased with her initial results.

capsulorrhaphy

implant exchange (3)

Because the patient is from Arizona, she will return home and keep in touch via email / phone calls and visit Dr. Pousti for her follow up appointments.

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


Increasing Breast Implant Size

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This 40 year old patient from Temecula, California previously had a breast augmentation performed by double board certified plastic surgeon, Dr.Pousti. Below, is a photo of her before her initial breast augmentation surgery. Although she was very happy with her results after her breast augmentation surgery she wished that she had gone larger in breast implant size.

revisionary surgery

implant exchange (3)

She came in for a follow up with Dr.Pousti about a couple months post breast augmentation surgery and expressed her interest in revisionary breast surgery or larger re-augmentation surgery with Dr.Pousti. He deemed her a good candidate for revisionary breast surgery, however, he wanted to wait a couple of months to let her think about it a bit more before they proceeded with surgery. She came back in a couple of months later and was ready to proceed with surgery to increase the size of her implants. They discussed the surgery in detail and about  a month later they proceeded to the operating room.

implant exchange

revisionary breast surgery

implant exchange (2)

This is the patient prepped and ready for revisionary breast surgery. Markings were completed with Dr.Pousti the morning of her surgery and all questions were answered before they proceeded to the operating room.

implant exchange (2) - Copy

revisionary breast surgery (2)This is the patient directly after surgery with implants exchanged. She went from 450cc/480cc smooth round moderate plus saline implants produced by the Mentor corporation to 760cc smooth round high profile saline implants produced by the Mentor corporation. She is currently doing well, healing without any complications, and is very pleased with her implant size.

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Posted in Breast Revision Surgery, Implant Exchange, XL Breast Augmentation


Breast Implant Revision with Biosynthetic Mesh and Internal Bra

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This 45 year old patient from Covina, California has been interested in revisionary breast surgery to improve the position of her breast implants.  She wanted them “more perky” with “more fullness” on top.

implant exchange

revisionary breast surgery

After discussing revisionary breast surgery with Dr. Pousti as well as her goals,  Dr. Pousti suggested the use of  biosynthetic mesh for additional support as well as the an internal bra procedure to improve her bottoming out. Bottoming Out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. This is corrected by “raising” the inframammary fold using internal sutures. This is performed after careful measurements are made from the areola to the “new” inframammary fold.  The internal bra or 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. She agreed and they decided to proceed to the operating room soon thereafter.

XL breast augmentation

Dr.Pousti performs markings and measurements the morning of surgery as he discusses the procedure and the patients goals one last time prior to the patient being put under anesthesia.

revisionary breast surgery (2)

mesh

A biosynthetic mesh was placed in each breast to help support the over-sized saline implant that will be placed in each of the patient’s breast. This is used because the skin on her lower breast poles were so thin to start with.  TIGR Matrix surgical mesh is primarily used to reinforce soft tissue where weakness exists. The mesh technology has a high strength for the first 6 months after implantation, and is completely degraded and resorbed after approximately 3 years. TIGR Matrix surgical mesh is being used to help aid correction of breast implant complications such as bottoming-out, capsular contracture, implant repositioning, breast asymmetry, lateral displacement, unnatural implant movement, and more.

implant exchange (2)

XL breast implants

breast liftAbove, is the patient immediately after her surgery. She went from 455cc to 800cc smooth round high profile implants produced by the Mentor corporation. She also received a revisionary breats lift, an internal bra inferiorally and laterally, and the biosynthetic mesh in both breasts. She is only a few days out from surgery and is healing quite nicely.

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Posted in BioSynthetic Mesh, Bottoming Out, Breast Pocket Correction, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), XL Breast Augmentation


Revisionary Breast Surgery with XL Breast Implants

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This 30 year old patient from Houston, Texas was interested in revisionary breast surgery. She previously had a breast augmentation procedure performed by another plastic surgeon and after years went by she was unhappy with the outcome. She wanted to go larger in size and she began to do some research on the internet about plastic surgeons around the world and came across double board certified plastic surgeon, Dr.Pousti. Because she lived out of the area, she decided to start the process with an email consultation with Dr. Pousti.

revisionary surgery

After sending photos and past history for Dr. Pousti to review, she was found to be a good candidate for revisionary breast surgery. It was discussed that Dr. Pousti would remove her previous breast implants and exchange them for overfilled saline implants and also perform the internal bra (capsulorrhaphy) for better placement and support of the XL breast implants.

implant exchangeShe felt very confident that Dr.Pousti was the right surgeon for her that she decided to fly in for surgery shortly thereafter. Below, is the patient directly before surgery with markings that were completed with Dr.Pousti the morning of her surgery. The red arrows indicate where the patient is wanting “more fullness”.

XL breast augmentation

revisionary breast surgery

saline overfilled breast augmentationThis is the patient directly after surgery. Her implants were exchanged and and internal bra was performed for each breast. Her 425cc implants were replaced with 1150cc saline overfilled implants. She is currently doing well and is healing without complications. She will continue to follow up with Dr.Pousti throughout her recovery process.

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Posted in Overfilled Saline Breast Implants, XL Breast Augmentation


Saline Overfilled XL Breast Implants

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This 32 year old patient from San Francisco, California previously had a breast augmentation surgery performed by another surgeon. She was ready to go larger in size with her implants and decided it was time to take steps toward surgery. She began to do some research online and came across double board certified plastic surgeon, Dr.Pousti. He had a great reputation and so she decided to reach out to him via email to discuss her issues and options towards revisionary breast surgery.

breast implants

revisionary breast surgeryDr.Pousti deemed her a good candidate for revisionary breast surgery and they decided they would proceed with surgery. She wanted to go very large in size so it was decided they would go forward with an XL breast augmentation. This would be achieved with overfilled saline implants.

revisionary surgery

saline overfilled implants

Above, are a couple of photos of the patient immediately before and after surgery. She went from 450cc to 1300cc saline overfilled implants produced by the Mentor company.

implant exchange

This is the patient 9 days out from revisionary breast surgery. She has some bruising and swelling but is healing very nicely and loves her results. She will keep Dr.Pousti updated through phone calls and emails as time goes on.

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Posted in Breast Revision Surgery, 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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