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Areola Reduction Patients

Breast Asymmetry

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This 44 year old female from San Diego, California currently has implants from a surgery performed by another surgeon 6 years ago. She is currently unhappy with the size of her areola and the asymmetry present in her breasts. She presented with bilateral breast hypoplasia/ptosis and left implant displacement (inferior and lateral). She desired breast revision surgery. She was referred to Dr. Pousti by a friend and satisfied previous patient who was very happy with the work he had performed. before remove and replace of implants with internal bra, areola reduction, and unilateral breast lift

Dr. Pousti, a double board certified plastic surgeon, met with this patient and discussed the procedure that would best help her achieve her goals along with the possible risks involved. The patient proceeded with surgery. The markings were performed on the morning of the procedure and the patient and Dr. Pousti get a chance to go over the surgery one last time.

side view before remove and replace of implants with internal bra, areola reduction, and unilateral breast lift

After all questions were answered, the patient was taken to the operating room. The patients current implants were removed. Capsulorrhaphy (internal bra) was performed to close off the breast pocket and reduce implant displacement. A stage 1 breast lift was performed on the right breast and a stage 3 breast lift was performed on the left breast. New cohesive gel breast implants were used to help the patient achieve the fullness she desired. The incision lines are closed and the patient is taken to recovery.

remove and replace of implants with internal bra, areola reduction, and unilateral breast lift

The patient is shown below 2 months post surgery. She has 495cc (left) and 595cc (right) high profile Sientra silicone gel breast implants.

after remove and replace of implants with internal bra, areola reduction, and unilateral breast lift

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Posted in Areola Reduction, Benelli Lift, Breast Asymmetry, Breast Lift, Breast Pocket Correction, Breast Procedures, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Limited Lift (Benelli Lift)


Breast Augmentation Unilateral Breast Lift to Camoflauge Chest Deformity

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This 22 year old female from Oregon flew in to San Diego in order to have her breast augmentation procedure performed by Dr. Pousti. The patient was unhappy with the asymmetry in her breasts and lack of tissue present. She presented with asymmetric breast hypoplasia and significantly asymmetric chest wall with very prominent skeletal structures along the medical aspect of each breast.  She desired to camouflage her chest deformity that occurred due to a lack of pectoral muscle on her left chest wall. She also desired to reduce the size of her right areola to achieve more symmetry.before breast augmentation silicone and unilateral areola reduction

While doing online research for a skilled and board certified plastic surgeon, she came across Dr. Pousti. She found his experience and amount of before and after photos to be very impressive. She began to communicate with Dr. Pousti via email and set up her surgery. She flew in and had her consultation and surgery the following morning.

side view before breast augmentation silicone and unilateral areola reduction

Below, the chest asymmetry is shown.

breast augmentation silicone and unilateral areola reduction

The patient is immediately post surgery and has 285cc (right) and 405cc (left) Sientra Brand Silicone Gel Breast Implants. The right areola has been reduced and the breasts have reached better symmetry.

after breast augmentation silicone and unilateral areola reduction

side view after breast augmentation silicone and unilateral areola reduction

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Posted in Areola Reduction, Areola/Nipple Procedures, Breast Asymmetry, Breast Augmentation, Breast Procedures, Keller Funnel, Petite Frame Breast Augmentation


Breast Revision With Use of Allograft

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This 35 year old patient from out of state flew in to have breast revision surgery performed by double board certified surgeon, Dr. Pousti. She was very unhappy after surgery performed by another surgeon. She was experiencing an implant rupture in her right breast, left breast palpability, and she desired her right areola to be smaller.
While researching on the internet, she found Dr. Pousti and was very interested in contacting Pousti Plastic Surgery for an online consultation. After communication via email, the patient decided to fly in and proceed with surgery. Her consultation was performed the day prior to surgery and the markings were performed the following morning.

markings for areola reduction, capsulectomy,  and implant exchange with use of allograft in left breast

Dr. Pousti recommended the use of Allograft for this patient to prevent palpability in the left breast. The Allograft will assist in this process by adding another layer if tissue between the skin and the implant.

alloderm for areola reduction, capsulectomy,  and implant exchange with use of allograft in left breast

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.

areola reduction, capsulectomy,  and implant exchange with use of allograft in left breast

Below, the patient is shown immediately post surgery and has bilateral 545cc high profile silicone gel breast implants.

after areola reduction, capsulectomy,  and implant exchange with use of allograft in left breast

The patient will continue to follow up with Dr. Pousti via email and pictures. The steri-strip tape around the areola will remain on for 4-6 weeks and help improve scarring.

post areola reduction, capsulectomy,  and implant exchange with use of allograft in left breast

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Posted in AlloDerm, Areola Reduction, Areola/Nipple Procedures, Breast Procedures, Breast Revision Surgery, Capsular Contracture, Implant Exchange


Tuberous Breast Deformity

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This 20 year old patient from Orange County was interested in breast augmentation surgery. She found Dr. Pousti when looking for a surgeon who was double board certified. She desired to improve her tuberous breasts.before breast augmentation silicone with tubular breasts

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. In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient.

side view before breast augmentation silicone with tubular breasts

Markings were performed and a sizer was used for symmetry of the breasts.

breast augmentation silicone with tubular breasts

Below is after the breast augmentation surgery.

after breast augmentation silicone with tubular breasts

side view after breast augmentation silicone with tubular breasts

This same patient came back and after several years of having breast implants and significant consideration, she decided to have her breast implants removed. The patient also desired to make the size of her areola smaller.

before aerola reduction and implant removal

She knew Dr. Pousti was happy with his professionalism and expertise so she proceeded with surgery to remove her breast implants.

side view before aerola reduction and implant removal

Below, the patient is post implant removal and areola reduction surgery.

aerola reduction and implant removal

aerola reduction and implant removal after

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Posted in Areola Reduction, Areola/Nipple Procedures, Breast Procedures, Implant Removal, Tuberous Breast Deformity


Breast Augmentation Revision-Capsulorrhaphy/Allograft/Nipple Reduction

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A 35 year old female from Ohio wanted to find a surgeon with revisionary breast augmentation experience.  She was unhappy with the malplacement of her left breast implant from a previous augmentation. Also, she was interested in areola reduction for her left breast.

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DSC08142

During her consultation Dr. Pousti let her know that she would be a good candidate for revisionary breast surgery using allograft (skin graft).  Feeling confident that Dr. Pousti will help her achieve her goal she decided to have him preform her breast augmentation revision surgery

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Dr. Pousti sits his patient’s upright during surgery to assure breast asymmetry.

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Allograft tissue used for Left Breast Augmentation as well as internal sutures for better breast implant placement on the chest wall.

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Immediately after Revisionary Breast Surgery (Left breast and nipple)

Patient is now 2 1/2 years post-op and very happy with her new look

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Posted in AlloDerm, Areola Reduction, Areola/Nipple Procedures, Breast Pocket Correction, Breast Procedures, Breast Reconstruction, Breast Revision Surgery, Capsulorrhaphy (Internal Bra)


Revision Breast Surgery with Capsulorrhaphy

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This 42 year old from Missouri was interested in breast revision surgery for over a year. She was unsatisfied with the shape, size, and asymmetry of her breast and began researched for an experienced board certified plastic surgeon. She found double board certified plastic and reconstructive surgeon Dr. Pousti. She was impressed with his credentials and years of experience with not only breast augmentation, but revisionary breast surgery. She was not satisfied with any of the plastic surgeons in her home state and decided to consult with Dr. Pousti to discuss her options.

Breast Revision

The patient exchanged several emails and telephone calls with Dr. Pousti and decided the trip to California was well worth it to have Dr. Pousti perform her breast revision procedure. Dr. Pousti met with the patient and after examining her determined the patient would benefit from capsulorrhaphy (internal bra for better implant placement on her chest wall) of her left breast, an implant exchange, and areola reduction based on her concerns. The patient felt extremely confident in Dr. Pousti’s ability to achieve her goals and was ready to proceed with surgery.

Breast Revision

Dr. Pousti and the patient met again prior to surgery to take measurements and perform markings. The markings are key in achieving as much symmetry as possible and serve as the foundation of the surgery. Markings are performed with the patient standing up and lying down to achieve accuracy.

Implant Exchange

The patient’s previous circumareolar incision was used to remove her implants to prevent any further scarring.

Capsulorrhaphy

Dr. Pousti removed the patient’s previous implants and performed capsulorrhaphy on her left breast. Capsulorrhaphy, or internal sutures, are used to repair the patient’s breast pocket and improve implant placement. The patient did not like how her left breast fell to the side when she was lying down. The internal sutures create an internal bra supporting the breast implant to prevent implant displacement. The patient did not like her areola size and wanted to improve both the size and shape. Dr. Pousti performed an areola reduction to achieve the patient’s desired areola size.

Implant Exchange

Sizer implants are used after the capsulorrhaphy was performed to determine what implant size was needed to achieve the patient’s goals. The sizer implant is placed into the breast pocket and filled with air until the patient’s goal breast size and shape has been achieved. The patient is sat upright several times with the sizer implants to preview potential results.

Breast revision

The patient wanted to achieve upper fullness and better symmetry. Dr. Pousti used 800cc saline implants and performed capsulorrhaphy, an areola reduction, and implant exchange to achieve the patient’s ideal breast.

Internal Bra

Breast Revision (Side View)

Breast Revision

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Posted in Areola Reduction, Breast Pocket Correction, Breast Revision Surgery, Capsulorrhaphy (Internal Bra), Implant Exchange


Breast Surgery for Correction of Tuberous Breast

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This 29 year old from Georgia was interested in a breast augmentation for several years. She found Dr. Pousti online after searching for an experienced board certified plastic surgeon. After exchanging several emails and telephone calls, the patient felt the trip to California would be well worth it to have Dr. Pousti perform her breast enhancement surgery so she flew into San Diego to meet with Dr. Pousti in person.

Tuberous Breast

Dr. Pousti examined the patient and determined she was a good candidate for a breast augmentation with correction of tuberous breasts as well as breast asymmetry.  Tuberous or constricted breasts, usually have a very narrow base and long skin envelope. The areola can also appear puffy or enlarged. Dr. Pousti discussed the pros and cons of saline vs silicone gel implants and the patient decided to proceed with a silicone gel breast augmentation surgery with correction of her tuberous breast.

Tuberous Breast

The patient and Dr. Pousti met again the night prior to surgery to review the planned procedure in detail. During this appointment, measurements and markings are also performed. Markings are key in achieving as much symmetry as possible.

Tuberous Breast

Markings are checked several times prior to the start of surgery. The patient and Dr. Pousti met again in the pre-operative room at the surgery center to reinforce markings and make any necessary changes needed.

Tuberous Breast

Dr. Pousti used sizer implants to determine what size implant was needed to achieve the patient’s ideal breast size and shape. The sizer implant was placed into the breast pocket and filled with air until the patient’s goal size was achieved. Once sizing in noted, the temporary implant was removed and the silicone gel implant was prepped for placement using the Keller Funnel method. This method uses a sterile funnel to easily place the breast implant into the breast pocket.  For this patient, the incisions were placed around the areola for improvement of areola asymmetry as well as correction of the “tuberous” breast.

Constricted Breasts

After placing the implant, Dr. Pousti performed correction of the patient’s constricted breast. This operation involves removing the fatty tissue of the areola, reducing the puffy areola.

Tuberous Breast

Dr. Pousti removed fatty tissue from both the left and right breast areola.

Tuberous Breast

A 350cc silicone implant was used on the right breast and a 325cc silicone gel implant was used on the left breast. Slightly different size implants were used to achieve as much breast symmetry as possible. The patients breast pockets were lowered to allow room for the breast implants and to give the patient a more rounded look, which is common with tuberous breast patients.

Constricted Breast

After Breast Augmentation (Side View)

Correction of Constricted Breast

Immediately after the procedure, steri-strips are applied to allow the incision to heal and to prevent the areola from spreading.

Constricted Breast

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Posted in Areola Reduction, Breast Asymmetry, Tuberous Breast Deformity


Breast Revision Surgery with Breast Lifting

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This 33 year old patient from San Diego, California was interested in breast revision surgery. She was extremely unsatisfied with her breast augmentation which was performed by a different surgeon. She did not like the shape, placement, or size of her implants and was interested in revisionary breast surgery. She understood the importance of choosing a qualified surgeon and researched surgeons with breast reconstruction experience. She found double board certified plastic and reconstructive surgeon, Dr. Pousti and was extremely impressed with not only his credentials, but the results he was able to achieve for his previous breast revision patients.

Breast Revision

Upon examination, Dr. Pousti determined the patient would be a great candidate for breast revision surgery. He recommended an implant exchange, a breast lift, and areola reduction to achieve the patient’s goals. Dr. Pousti and the patient discussed saline vs. silicone implants and the patient decided to proceed with saline implants. Dr. Pousti and the patient met in the pre-operative area to take measurements and perform markings.

Mastopexy with Implants

These markings are used as a guideline during surgery and help to promote symmetry. The “x” indicates the new location of the nipple/areola complex.

Breast Lifting

Before Breast Revision

The mastopexy procedure involves lifting and rearranging of the breast tissue to achieve a more pleasing position of the breast. Usually after pregnancy and breast feeding, a breast lift is needed to achieve “perkier” and fuller breasts. The areola is also reduced during the breast lift in certain cases to promote better symmetry and a more pleasing results. The patient’s previous implants were removed and sizer implants were used to determine sizing. The sizer implants are placed in the breast pocket and pumped with air until the patient’s goal size has been achieved. The patient is then sat upright to check for symmetry and breast fullness.

Breast Revision Surgery

Dr. Pousti removed the patient’s previous implants, performed a stage 3 breast lift along with areola reduction, and used 660cc saline implants to achieve the patient’s goals.

Breast Lift with Augmentation

She is extrememly satisfied with her results.

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Posted in Areola Reduction, Breast Lift, Breast Lift with Implants, Breast Revision Surgery


Breast Augmentation with Correction Of Tuberous Breasts

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This 24 year old from India was unhappy with the size and shape of her breasts and was interested in breast augmentation with correction of tuberous breast deformity. She began researching board certified surgeons to perform her breast enhancement surgery, but was left disappointed by the surgeons in her area. She began further research on blog sites regarding plastic surgery and read through several forums regarding double board certified plastic and reconstructive surgeon, Dr. Tom Pousti. She was extremely impressed with volume of positive testimonials he had and decided to contact him.

Tuberous Breasts

The patient sent Dr. Pousti an email about her concerns along with pictures for his review. Dr. Pousti and the patient corresponded several times via phone and email and she felt confident that he was the right surgeon for her. The patient decided to fly in to California to have her breast procedures performed. Prior to surgery markings are performed and discussed in detail. Dr. Pousti also reviewed the procedure with the patient and explained that a stage 1 breast lift around the areola would be her best option to correct the tuberous breasts.

Breast Augmentation

Dr. Pousti suggested the patient bring in goal pictures to illustrate exactly what she wanted to achieve with her breast augmentation. These pictures are hung up on the wall in the operating room for Dr. Pousti to refer to during surgery. Markings are performed prior to surgery and used as a guideline during surgery to achieve as much symmetry as possible.

Before Breast Augmentation

Breast Enhancement

In the operating room, sizer implants are used to determine final implant sizing. These deflated sizer implants are placed into the breast pocket and filled with air until the patient’s desired goal size has been achieved. Once sizing has been determined, the patient is sat upright to check for symmetry, cleavage, and fullness. The sizer implant is then removed and the final implant is prepped for surgery.

Constricted Breasts

Underneath the areola excess breast tissue was present causing the areola to appear “puffy”. To fix this, the extra tissue was removed from underneath each areola for better results.

Tuberous Breasts

The areola is also reduced in size to promote better symmetry and results.

Breast Augmentation (Side View)

Breast Enhancement

When placing silicone gel implants, Dr. Pousti uses the Keller Funnel method. This technique allows for easy distribution of the implants to the breast pocket and promotes better control of contamination with a no touch method to the implants during placement. Dr. Pousti used 450cc silicone gel implants, along with an areola reduction, and correction of tuberous breasts to achieve the patient’s goals.

After Breast Augmentation

Breast Augmentation

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Posted in Areola Reduction, Areola/Nipple Procedures, Benelli Lift, Breast Augmentation, Kenner Funnel, Silicone Gel Implants, Tuberous Breast Deformity


Correction Of Tuberous Breasts And Breast Augmentation

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This 22 year old from Canada was interested in a breast augmentation for several years. She was mainly concerned with increasing her breast size and fullness while correcting her tuberous breasts. Tuberous breasts have a long narrow base and a long skin envelope with a “puffy” and enlarged areola. She began researching online for a qualified surgeon to perform her breast enhancement surgery and found double board certified plastic surgeon, Dr. Pousti. The patient read through several patient testimonials and was very impressed with the results he was able to achieve for his patients.

Breast Augmentation

After exchanging several emails and telephone calls the patient decided to fly in to California to have her surgery performed. Upon her arrival, Dr. Pousti examined the patient and confirmed she was a great candidate for breast enlargement surgery with an incision around the areola to reduce the areola size and correct the tuberous breasts. The patient brought in goal pictures to illustrate exactly what she wanted to achieve with her surgery and reviewed them with Dr. Pousti prior to surgery.

Breast Enhancement

Dr. Pousti met the patient the night prior to surgery to perform markings and discuss saline vs. silicone implants. The patient decided to proceed with her breast augmentation surgery using silicone gel implants. The smiley face on the patient’s right breast represents mild asymmetry, different implant sizes will be used to achieve breast symmetry. Dr. Pousti uses sizer implants in the operating room to determine an appropriate implant size. The sizers are placed into the breast pocket deflated and then pumped with air until the patient’s goal size has been achieved based on pictures she has brought in. The patient is then sat upright to check for symmetry, cleavage, and fullness. At this time adjustments are made prior to final implant placement.

Breast Enlargement

Dr. Pousti uses the Keller Funnel method when placing silicone gel implants. This technique allows for a no touch method to the implants during placement which reduces the risk of contamination. The implants are easily distributed to the breast pocket through a funnel with a simple squeeze. Dr. Pousti used a 600cc silicone gel implant on the left breast and a 575cc silicone gel implant on the right breast to create better symmetry. An areola reduction was also performed to treat the constricted breasts.

Breast Enhancement

The patient is extremely satisfied with the results of her breast procedures.

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Posted in Areola Reduction, Breast Asymmetry, Breast Augmentation, Kenner Funnel, Silicone Gel Implants, 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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