Capsular Contracture Patients

This 37 year old patient from Menifee, California had a breast augmentation performed in 2000 by a previous surgeon and was very unhappy with her results. The patient did not like the fact that her breasts were very round and hard and at sometimes they were very painful.

After consulting with Dr. Pousti it was determined that the patient had capsular contracture present. This is also known as scar tissue which is formed around the breast implant. When scar tissue is present it can be very painful and if not fixed promptly it can become extremely painful.

After measurements and markings are done the patient is taken into the operating room to begin her revisionary breast surgery. The first step of the procedure is to remove her old breast implants and the scar tissue that has formed around them.

Once the implants and scar tissue is removed the patient’s breast pockets are then revised. Because she was interested in achieving more cleavage the pockets were opened up more in the center of the chest wall to allow for the implants to sit nicely.

Dr. Pousti used 350cc Silicone Gel Implants in the patient’s breasts to meet her size expectations.

Before Revisionary Breast Surgery

Immediately After Breast Revision

She is very happy with the results of her breast surgery.

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Posted in Breast Asymmetry, Breast Pocket Correction, Breast Reconstruction, Breast Revision Surgery, Capsular Contracture

This 29 year old patient from Murrieta, California (Riverside County) was interested in revision breast surgery.  She searched for an experienced San Diego Breast Revision Surgeon and found Dr. Pousti (who has an office in Murrieta where this patient lives).  She met with Dr. Pousti and felt comfortable with his expertise regarding Breast Augmentation Revision Surgery and decided to proceed with her surgery.

She was unhappy with the breast asymmetry, the difference in size of the areola.  Her right breast implant also had scar tissue that needed to be removed.

Dr. Pousti and the patient met the night prior to surgery and again the morning of surgery to take measurements and discuss the revisionary breast surgery in detail again.  Implant Exchange, Capsulectomy and areola reduction were discussed in detail.

Procedure Performed : Aerola Reduction, Revisionary Breast Augmentation, Capsulectomy, Implant Exchange

The patient is only a few weeks out from surgery but very pleased with the breast symmetry as well as the areolar symmetry.

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Posted in Aerola Reduction, Breast Pocket Correction, Breast Revision Surgery, Capsular Contracture

This is a 30 year old patient from Kalispell, Montana interested in a  revision breast re-augmentation after being left unsatisfied with her results from a previous surgeon. She was unhappy with the shape, symmetry, and placement of her previous implants. She also complained of relative right breast implant position being too far to the mid line of her chest and lower than her left breast.  The left breast had more scar tissue build up as well.

She searched for a good Plastic Surgeon who had experience with revisionary breast surgery and found San Diego Plastic Surgeon, Dr.Tom Pousti.  She needed to have her breast implants replaced and positioned better on her chest.  The scar tissue was also bothering her and she wanted that removed.

The patient underwent removal of the anatomic shaped breast implants she previously had placed and Dr. Pousti replaced them with new cohesive gel breast implants.

Internal suture repair, of the right breast area, and further bilateral breast implant pocket adjustments were done. Re -augmentation was completed with round and smooth Silicone gel breast implants.

This is the patient directly after re-augmentation surgery.  Note the better size and symmetry of the breasts.  She will have swelling and bruising that will subside with healing.

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Posted in Bottoming Out, Breast Pocket Correction, Breast Procedures, Breast Revision Surgery, Capsular Contracture, Internal Bra (Internal Sutures)

This 50 year old patient was interested in Revisionary Breast Surgery.  She had previously had 2 breast augmentation surgeries but was not happy with her results.  She had developed scar tissue and the breasts were now becoming painful.

She was referred to Dr. Pousti by a friend of hers and was impressed by his experience with revision breast augmentation surgery.  She was also concerned that her left breast was ruptured.  Dr. Pousti discussed implant exchange with new silicone gel implants as well as removal of the scar tissue and the ruptured silicone gel implant.

The markings indicate where the patient wants “more fullness” (red arrows).

In the operating room, the breast implants are removed.

Below are markings indicating the areas of “discomfort” and the patient feeling the “lymph nodes”.

Above is the tissue that was removed from her lymph nodes. The silicone rupture of her implant had gone to her lymph nodes and was causing pain for the patient.

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Posted in Breast Revision Surgery, Capsular Contracture

This 25 year old patient was so unhappy with her breast augmentation surgery and wanted to have revisionary breast surgery performed to address the issue of the scar tissue, breast asymmetry and also wanted larger fuller breasts.  Her left breast was encapsulated and was hurting her.

She did a lot of research online and was willing to travel to a surgeon whom she thought had lots of revisionary experience with breast implant surgery.  She found Dr. Pousti and saw that his experience in performing breast augmentation revisions was great and so she made a trip down from San Jose, California to meet with Dr. Pousti.   She immediately felt comfortable with Dr. Pousti’s experience with similar complicated breast cases and proceeded with scheduling surgery.

In the operating room, Dr. Pousti removed her current implants, removed the scar tissue on the left side, performed some pocket work for better symmetry and placed larger saline filled implants in to give the patient the “fuller, larger” look she was wanting to achieve.

During the procedure, the patient is sat upright multiple times for Dr. Pousti to view the size, symmetry and pocket dissection of the patient.  Adjustments are made each time to ensure as much symmetry as possible.

She now has saline implants filled to 1580cc and is very happy with her results.  She understands that it take time for things to heal and settle but is extremely happy with her revisionary breast surgery results at this time.

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Posted in Breast Pocket Correction, Breast Revision Surgery, Capsular Contracture

This 41 year-old patient from Chula Vista, California had breast augmentation surgery with silicone gel implants performed by a different surgeon in 1990. She was unhappy with her results and decided she wanted to get breast revisionary surgery.

The patient decided to search online for a plastic surgeon who specializes in breast revisionary surgery. While searching on the internet the patient came across Dr. Pousti, a Double Board Certified Plastic and Reconstructive Surgeon. During her examination with Dr. Pousti, he explained to the patient she had scar tissue that needed to be removed. Capsulectomy is a procedure in which the entire “capsule” of scar tissue surrounding a breast implant is surgically removed.

Measurements of the breasts are taken prior to surgery and markings of the entire revisionary breast surgery are done. The red arrows marked indicate where more fullness is desired.

Capsulectomy (Scar Tissue)

After the repairs, sizers are put in place and filled the patient’s desired look.

Immediately After Breast Revisionary Surgery

Dr. Pousti placed 457cc silicone gel-implants to achieve the patients desired look.

The patient is now 8 weeks post-op surgery and very pleased with her results.

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Posted in Breast Procedures, Breast Revision Surgery, Capsular Contracture

This 40 year old female patient was 20 years post subglandular breast augmentation performed by a previous surgeon. The patient had developed severe encapsulation both breasts along with ptosis(drooping of the breasts). Her previous surgeon had used MISTI gold breast implants filled with polyvinylpyrrolidone-hydrogel which, at the time, were thought to be a safe alternative to silicone but were discontinued after studies showed that they increased chances for capsular contracture (scar tissue formation).

Encapsulation can be very painful and uncomfortable and can cause the breast to have a ‘ball-like’ appearance. The patient found Dr. Pousti online after researching for plastic surgeons experienced in revisionary breast augmentation surgery and decided to proceed with removal of her current implants and replacement with the FDA-approved silicone gel implants.

Markings were done in the office the day prior to surgery, giving the patient ample time to understand the procedure and ask questions.

In the picture above Dr. Pousti explains to the patient where the incision for the mastopexy will be located

The ‘x’ marked on the breast indicate the new location of the areola and the red arrows show the new breast placement.

Above are the implants that were removed from the patient, as you can see they contained scar tissue and abnormal debris.

Once old implants are removed the lift is performed then a sizer is set in place to determine the size of the implant needed to provide the patient with her desired results. The breast is temporarily closed and the patient is placed in an upright position to be examined and insure symmetry.

After the breast lift was completed 420cc Silicone-filled implants were placed in both breasts to meet the patient’s size goals. Drains were placed, which is very common when the implant placement is switched from subglandular(under the breast tissue) to submuscular (under the muscle) to help remove fluid production and prevent seroma(accumulation of fluid).

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Posted in Breast Procedures, Breast Revision Surgery, Capsular Contracture

This 77-year-old patient from El Cajon, California had breast surgery performed by a previous doctor 21 years ago. She has silicone implants and has developed encapsulation (scar tissue around the implant). After years of discomfort caused by the scar tissue the patient decided proceed with revisionary breast surgery. While shopping for a plastic surgeon she found Dr. Pousti online and was impressed with his experience in reconstructive surgery.

After examination it is clear that the patient is in need of a mastopexy as well. Measurements and markings are done prior to surgery. The arrows indicate where the top of the implant should be and the ‘x’ where the areola should be.

After old implants and scar tissue is removed, lifting of the nipple-areola complex and tightening up the skin envelope is done.

The patient is post op removal and replacement of breast implants, mastopexy and capsulectomy and is extremely pleased with her results.

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Posted in Breast Asymmetry, Breast Reconstruction, Breast Revision Surgery, Capsular Contracture

This 31-year old patient from Coronado, California was unhappy with the results of her right breast from her previous breast surgery performed by another surgeon in 2008. She wanted  revisionary breast surgery.

With reoccurring encapsulation in her right breast, the patient was interested in breast reconstruction surgery. She had heard about Dr. Pousti from a friend and that he is a double board certified plastic and reconstructive surgeon with many years of experience and training. She met with Dr. Pousti in his La Jolla office to express her concerns, and decided to proceed with breast revision surgery of her right breast.

Markings were performed on the right breast. You can see the degree of asymmetry between the right and left breast.

Along with performing capsulorrhaphy (internal sutures), Allograft would be added to the right lower breast to strengthen the breast pocket.

AlloGraft: 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.

AlloGraft in place for breast reconstruction.

Dr. Pousti decided that her previous saline breast implant was able to be safely re-used and filled to match the left breast for symmetry.

Immediately after surgery.

A bolster dressing is made to hold and protect the corrected areas. Typically, this dressing is worn for about 2-weeks while in the internal suture are healing.

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Posted in AlloDerm, Breast Pocket Correction, Breast Procedures, Breast Reconstruction, Breast Revision Surgery, Capsular Contracture, Internal Bra (Internal Sutures)

This 42-year old patient did an online research for an experienced revisionary breast surgeon. She previously had breast augmentation surgery in 1999, performed by another surgeon and was unhappy with the size and placement of her breast implants.

She found Murrieta Board Certified Plastic and Reconstructive Surgeon, Dr. Pousti and decided to undergo breast implant revisionary surgery to reduce in breast size and correct implant displacement.

Due to the mal-position of her breast implants, Dr. Pousti performed capsulorrhaphy (internal sutures) and re-augmented with saline breast implants filled to 260cc in both breasts.

Before Surgery

She is very happy with her new look and breast size.

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Posted in Breast Revision Surgery, Capsular Contracture, Internal Bra (Internal Sutures)