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San Diego Cosmetic Plastic Surgery

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Extended Tummy tuck Patients

Extended Abdominoplasty and Breast Reduction Combination Surgery with Liposuction

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This 41-year-old patient from Temecula, California had been unhappy with the shape of her body for several years and decided to look into cosmetic surgery. After loosing  more than 70lbs she was still uncomfortable with her appearance and felt that she would greatly benefit from a mommy makeover. She began researching mommy makeovers daily and found that over half the pictures she looked through were all Dr. Pousti’s patients. She wanted to find a surgeon that was not only board certified but also experienced in the breast and body procedures that she was interested in and felt Dr. Pousti exceeded all of her expectations.

Mommy Makeover

Extended Tummy Tuck

After having 2 children and loosing the weight associated with pregnancy, she was left with a lot of excess skin in her breasts and abdomen. After meeting with Dr. Pousti it was determined that the best option was to proceed with the mommy makeover.

Mommy Makeover

Mommy Makeover procedures are combinations of breast and body procedures. In this patients case, she would greatly benefit from a breast reduction, extended abdominoplasty, and liposuction of her flanks and back.

Mommy Makeover

Breast Reduction

Prior to the Mommy Makeover procedure the patient and Dr. Pousti meet several times to discuss options, possible risks and the entire procedure in detail. On the last appointment before the surgery measurements of the patient’s breasts, abdomen and lower back are taken. These measurements are marked and are used as guidelines for the procedures that are to be performed.

Abdominoplasty Markings

Extended Tummy Tuck

On the patient’s breast the ‘x’ markings indicate where the new location for the nipple/areola complex will be located. The excess skin under the breast will be removed and the breast tissue will be re-arranged to give the patient a nice ‘perky’ look she is looking for. The red horizontal lines drawn on the patient’s abdomen and back are where the incisions for the abdominoplasty will take place. And lastly the circular lines indicate liposuction areas.

Prior to the Breast Reduction Portion of the Mommy Makeover

Breast Reduction

During most breast reduction procedures or breast reduction procedures a ‘tailor tacking’ technique is used. This technique is used to help insure that symmetry is achieved and is also used to see what the final result may look like prior to making final incisions.

‘Tailor Tacking’ on Right Breast in Operating Room

Breast Reduction

Immediately After Mommy Makeover Surgery in Operating Room

Once the breast portion of the procedure is completed Dr. Pousti moves onto the abdominoplasty. During the abdominoplasty not only is the patient’s excess skin removed but Dr. Pousti performs muscle repair as well. This gives the patient a nice tight abdomen and small waistline as well. Another part of the abdominoplasty procedure is the revision of the belly button’s appearance. The belly button must be revised because the abdomen tissue has been brought closer together and the old belly button location often lies on/near the incision lines. Immediately a desirable waistline has been achieved.

Mommy Makeover

Below is a picture of the patient 1 week post-op in recovery from her mommy makeover. A walker is used to aide during recovery, since the patient must remain in a hunched over position to protect the incision.

Mommy Makeover

The patient is now 3 weeks post-operative and is extremely satisfied with her extended tummy tuck, breast reduction, and liposuction results! Although swelling is still present, the waistline is already much smaller and will continue to shrink.

Mommy Makeover

Testimonial:

I am a 41 year old and have been fighting my weight gains and losses ever since I was 23 years old. In high school I thought I looked okay. It wasn’t until I married and had 2 children that my weight problem got serious. Every year the pounds just kept adding up until I was at 265 pounds and didn’t know how I got there. I tried many different weightless programs, and always seemed to put the weight back on just as fast as I lost it.

After 2 years of hard work at the gym and watching what I ate, I managed to loose 80 pounds, which left me with what I called my “skin tutu” around my middle and my breast hung down to my waist, which my kids referred to as my “cuddle buddies” because they laid on the bed next to me.

The more I lost the worst I looked! I wanted to love the body I worked so hard to get, but that isn’t what happened. The skin would just hang worse every pound I lost I wanted to love my body.

I started looking on the Internet at “mommy makeovers” before and after pictures, and at people like me who lost a lot of weight, and wanted the skin removed. I would say for every 10 women that I found, that I looked like in there before pictures, and loved their after pictures, 8 out of those 10 women were done by Dr. Pousti.

I looked at before and after pictures for at least a year prior to my surgery, wondering if I should do this or not. I was scared of what was involved and how I would look after. I didn’t want to look like one of those women who have surgeries and look worse afterwards.

Well, with the love and support of my fiancé, my children, my parents and my friends, I decided to make an appointment for a consultation with Dr. Pousti.

The day of my consultation, my fiancé and my mother came with me to my appointment. We went to Dr Pousti’s office in Murrieta, Ca. The moment I walked in, it felt so right. The women who work there were not just stunningly beautiful on the outside, but on the inside. They made me feel so comfortable and at ease! Dr. Pousti came in and looked at me and said he thought I would have amazing results. He suggested having an extended tummy tuck and a breast reduction, with some liposuction.

I weighted in at 207 and knew I had more weight to lose. I wanted to have this surgery in January when my business is slower. Dr Pousti suggested that an ideal weight he would like me to be for surgery was 180 pounds. Well, I was within a few pounds of my goal when surgery day arrived.

About 1 month prior to my scheduled surgery, my fiancé found out he had Thyroid Cancer. I wasn’t sure if I should cancel my surgery with Dr. Pousti. When I came in to see Dr. Pousti he could see I was nervous about my fiancé’s news. Dr Pousti asked who the surgeon was and he personally called every ENT Dr. That he knew to see if anyone had heard of this surgeon, and what his experience was. He called me personally the next day to tell me of his findings. Dr Pousti didn’t have to make those calls, but he did, and that meant the world to me. He doesn’t just care about me, but also about the man I love. My fiancé had his surgery and it was a success!

The day before my surgery my fiancé, and my mother came with me to Dr Pousti’s office in La Mesa ca. He did all his markings of what was going to remove, where he would cut and where he would lipo. He marked my breast so I would have my best results.

We stayed at my aunt’s house ,which was close to the surgery center, and is where I stayed for the first week after surgery. My mom was my nurse for the first week! I can’t thank her enough for helping me. I stayed at my aunts because Dr. Pousti wanted me to stay close by so he could check on me post surgery.

The day finally arrived, and we arrived at the surgery center. Dr Pousti uses the same surgery center, with the same anesthesiologist and the same nurses and assistants. I was so scared and everyone calmed me and made me feel comfortable and so special. They were very professional, and they had a way of making you feel like you were their only patient! Dr Pousti came in and checked his marking and did some minor adjustments,and then they took me back to the operating room. I woke up 8 hours later 6 hour surgery 2 hours of recovery, and I felt like I just got there.

The feeling I had was the feeling of tightness! I’m not going to lie week 1 was the hardest week but it was worth it! He installs a pain pump that numbs the incision area. I had 4 drains 2 from my breast and 2 from my pelvic area. They sent me home the same day of surgery. I really don’t remember too much as I was still really groggy.

I stayed at my aunts house and slept in a recliner for the first week. Dr Pousti and his wife  were so kind to check on me the first night after surgery! They even brought me flowers! Never have I heard of a Dr. doing this before. The compassion and love he has for his patients is very apparent! He has always made me feel like I was his only patient, and his # 1 priority, even though I know he has many more patients.

The nurse or office staff called me everyday to check on me! Everyday was easier than the day before. I got around with my trusty walker, my BFF after surgery!

Dr Pousti told me that after surgery you go through an emotional state, but what found was not what I expected at all! I was expecting tears of pain and thought of regret, but that isn’t what I had at all! I never once thought why did I do this? The emotions I felt were eye opening to my life! The tears I shed were tears of love and joy and how lucky I am to have parents who took care of me for 6 weeks, a fiancé who supported me, no matter what I wanted to do, and my daughters, who stood by my side the whole time. Then the flowers, the cards, and the text messages came from friends, and clients thinking about me. The love I felt was overwhelming! Every tear I shed, were tears of joy of my life, my new body, and my new life to come!

This whole experience was the best thing I could have ever done! The most important thing is I truly feel like I was led to Dr. Pousti, and the results I got are amazing! He is a true artist of the body! He knows what will look the best and what is needed and not needed. He doesn’t just make you feel like he’s just your surgeon, but your friend, with your best interests in mind! The surgery is going to change my life for the better, and can’t thank him enough!

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Posted in Abdominoplasty, Breast Reduction, Extended Tummy tuck, Liposuction, Mommy Makeover, Post-Weight Loss


Extended Abdominoplasty, XL Saline

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This 30 year old patient was interested in Body Contouring Surgery after massive weightloss. She had lost 80lbs after having gastric bypass surgery and was interested in revisionary breast surgery along with abdominoplasty. She wanted an extra large, overfilled implant.

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This patient is from Austin, Texas and after doing extensive research online decided that the travel to San Diego, California to see  board certified plastic surgeon Dr. Pousti, was well worth it.

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During her visits with Dr. Pousti he explained the revisionary breast procedure and abdominoplasty surgery in detail. Dr. Pousti explained the potential risks and complications associated with both tummy tuck surgery as well as getting extra large breast implants.  The patients understood and agreed to proceed with surgery.

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Posted in Abdominoplasty, Extended Tummy tuck, Overfilled Saline Breast Implants, Post-Weight Loss, XL Breast Augmentation


Mommy Makeover Procedure

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This 26-year old mom of 3 from Kentucky researched for a mommy makeover specialist and found San Diego Plastic Surgeon, Dr. Pousti on the Internet. She was concerned about her breasts, tummy, and sides after losing 50 lbs of pregnancy weight.  She was unhappy with the asymmetry of the breasts and wanted them more symmetrical, fuller and perkier.

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The patient contacted Dr.Pousti via e-mail, after several consultations, the patient decided to fly in and proceed with breast surgery as well as tummy tuck surgery.

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After deciding on a surgery date, the patient flew into San Diego a week before her mommy makeover surgery. She met with Dr. Pousti the night before surgery to have markings performed.  The markings are performed with careful measurements to use as a “road map” in the operating room.

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The night before and the morning of surgery, Dr. Pousti is able to mark the details of the mommy makeover procedure that she will be getting and answer any questions the patient may have before proceeding with surgery.

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In order to shape and contour her back and sides, an extended tummy tuck as well as liposuction were performed in her back, flanks, and upper abdomen.

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Dr. Pousti corrected the placement and size of her areola with breast lifting surgery. Saline filled implants were used and filled to 630cc in both breasts and placed under the muscle.  The size of the areola are also reduced during this breast lift surgery.

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Completed mommy makeover. Immediately after surgery you can see the flatter tummy from the abdominal muscle repair.

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Posted in Abdominoplasty, Breast Asymmetry, Breast Lift with Implants, Extended Tummy tuck


Breast Reduction / Lower Body Lifting

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This 43 year old patient was unhappy with her breasts and tummy and was looking for a San Diego Plastic Surgeon to help her with her body make over.   She visited a few surgeons but felt comfortable with San Diego Plastic Surgery Specialist Dr. Pousti.

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She discussed with Dr. Pousti that her large breasts gave her neck, back and shoulder pain and she didn’t like how they “sagged”.  She wanted her breasts smaller and perkier.  She and Dr. Pousti discussed a breast reduction / breast lifting surgery.

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Her abdomen and back had loose, damaged, hanging skin.  She and Dr. Pousti discussed an extended tummy tuck (abdominoplasty surgery as well as back lipectomy) to address the front, back and muffin top area as well.

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After meeting several times, they  decide to proceed with surgery.  Markings are performed prior to surgery.  For the breast reduction/lift procedure, San Diego Breast Surgeon Dr. Tom Pousti takes careful measurements and indicates where the new nipple/areola complex will be after surgery.

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The Lower Body Lifting surgery will include the tummy tuck, back lipectomy and liposuction in areas where it is indicated and safe.Again, careful measurements are taken.

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Below, you see the “red” line which shows where the scar will be and the “purple” section is the section that will be completely removed.

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When the back is completed, the patient is turned onto her back so that the tummy tuck and breast procedures can be performed.

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Below shows the abdominal muscles that have separated and will be put back together.

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In the operating room, the right breast has been reduced and lifted.  See the dramatic difference between the right and left breasts.

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When a breast lift/reduction is performed, the areola are also reduced in size to give a more natural, symmetrical look for the patient.

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Immediately after breast reduction and lower body lifting surgery.

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Posted in Abdominoplasty, Body Contouring, Breast Lift, Breast Reduction, Extended Tummy tuck, Liposuction


Mommy Make-Over

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This 27 year old nurse from San Diego was looking for an experienced  Mommy Makeover Plastic Surgeon to perform her breast augmentation and tummy surgery.  Because she is in the medical field, she knew to look for a Board Certified Plastic Surgeon for her procedures.

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She was unhappy with the shape and size of her breasts and she wanted them larger and fuller on top.  After having children, her abdominal area was stretched out and no matter how much she exercised, she could not improve the area.  She wanted that excess damaged skin and tissue removed.

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When she bent over, you can see the separation of the abdominal muscle and how the abdomen is NOT tight.  After meeting with Dr. Pousti, she decided to proceed with breast augmentation surgery as well as an extended tummy tuck.  An extended tummy tuck would take the incision into the back to get rid of the “muffin top” that the patient did not like.

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After meeting several times, they decided to proceed with surgery and met one more time prior to surgery for the “markings”.  These markings and measurements are checked and re-checked so that the surgery can go as smoothly as possible.  Below is Dr. Pousti drawing on the patient’s back area as to what areas will be removed.  The “swirl / circles” on her back indicate where liposuction will be performed.

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On the front of the patient’s abdomen, measurements again are made so that Dr. Pousti can remove enough tissue to give the patient “the look” she is wanting without compromising the recovery.

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Above you will see the patient before surgery is performed on her back, below is after the back lipectomy is completed.  This gives a very nice definition.

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After the back lipectomy is completed, the patient is rolled onto her back so that Dr. Pousti can work on the breast implants and the tummy tuck. The patient chose silicone gel implants for her procedure.

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Below, you will see the patients abdominal muscles that have been separated (the dark lines running up and down with clamps on them).  During the abdominoplasty surgery, these abdominal muscles will be brought together and sutured all the way down and this will give the patient the result of a “tight tummy” after surgery.

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BEFORE Mommy Make Over Surgery

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IMMEDIATELY AFTER Mommy Make Over Surgery

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Posted in Abdominoplasty, Breast Augmentation, Breast Procedures, Extended Tummy tuck, Mommy Makeover, Silicone Gel Implants


Breast Reduction / Breast Lifting/ Extended Tummy Tuck

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This 43 year old patient from Fallbrook, California had been interested in a total makeover for quite sometime and finally decided that it was her time to do this for herself.  She wanted her breasts lifted and the asymmetry corrected as well as wanting the excess skin and adipose tissue around her abdominal area and back removed completely.  She had some weightloss but was left with sagging skin.

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The excess skin under her armpits (axillary tissue) also bothered this patient and she wanted that removed as well.

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She and her husband went online to do research to find a Southern California Plastic Surgeon for her procedure

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Being unhappy with her body, she decided to fine the best plastic surgeon to take care of her. She wanted a Board Certified Plastic Surgeon with lots of experience with mommy makeovers. Safety was a concern for this patient and she wanted to make sure whoever she chose, would be performing the procedure in a safe setting.

 26After examination of the patient, Dr. Pousti discussed breast lifting as well as breast reduction surgery, removal of the axillary tissue at the same time, and extended tummy tuck.  The extended tummy tuck and flank lipectomy will help improve the patient’s contour of the back and take care of the “muffin top”.  Liposuction would also be performed but only to the extent that was safe.  The patient was happy with her meeting and the procedures that were going to be performed so she proceeded with scheduling surgery.

 7Markings were performed the night prior to surgery.

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The breasts were measured and marked accordingly.  The “x” marks the new position of the nipple/areola complex after the breast lift / breast reduction is performed.

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The abdomen and back were also marked and all of the procedures were discussed one more time with the patient and her husband.  The excess skin and tissue from her belly button down to her pubic area will be removed completely. The area in purple on her back indicates the tissue that will also be removed (the “red” line is where the final incision will be).

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In the operating room, the patient starts off laying prone (on her stomach) so that the back can be worked on first.  After the back is completed, the patient is then turned over to work on her breasts and abdomen.

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Dr. Pousti removes the excess skin and adipose tissue of the back/flank area (back lipectomy) and then performs liposuction to improve the contour of the back area prior to suturing things together.

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Dr. Pousti will now start working on the patient’s breasts.  She wanted them reduced in size and “more perky” so a breast lift / breast reduction was performed.  Here you can see  1 side is completed and what a dramatic difference there is between the two breasts. No breast implants were placed for this patient.

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The areola size is also reduced during the breast lifting surgery to improve the aesthetic results.

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The abdomen is opened and the abdominal muscles that have separated are located (the clamps above).  The abdominal muscles are then brought together and sutured together to give the patient the “tight tummy” she wanted.  Above you see the dark lines running up and down that are separated and below those muscles have been sutured together (one line running up and down the abdomen).

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The excess skin will now be removed (the triangular tissue below).

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The excess skin is removed and then multiple layers of closure are performed to close the incision line.

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The patient is still very fresh out of surgery but is extremely happy with her new body.  She will take it easy for a few months until all incision lines have healed.  Swelling will remain for months.

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Posted in Body Contouring, Breast Asymmetry, Breast Lift, Breast Reduction, Extended Tummy tuck, Mommy Makeover, Post-Weight Loss


Body Lifting after Massive Weightloss

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This 30 year old Mom of 1 from Temecula, California (Riverside County) had lost a significant amount of weight and was wanting to improve herself before getting married this fall.  She wanted a mommy makeover with breast surgery as well as tummy tuck surgery.

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She wanted more fullness in her breasts and wanted all of the excess skin and adipose tissue from her abdomen and flanks removed.  She had lost over 135 pounds just be eating right and exercising and she was ready for a change.

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She and her family searched online for a Southern California Plastic Surgeon with experience in performing mommy makeovers (breast augmentation, breast lifting and abdominoplasty surgery).  They found Dr. Pousti and communicated via email and then came in for the consultation.  She and Dr. Pousti took a look at her skin elasticity as well as her current breast tissue and her goals to be “much bigger” and decided to proceed with breast augmentation with overfilled saline implants, benelli breast lift and extended abdominoplasty (tummy tuck that extends into the back with a flank lipectomy).

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Dr. Pousti performed markings the morning of surgery.  The markings involve Dr. Pousti taking measurements, drawing on the patient as to how the procedures will take place and going over the procedures in detail with the patient one more time.

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The measurements are checked and re-checked prior to surgery.   You can see below all of the measurements on the patient’s back.  Dr. Pousti takes great care to remove as much as possible without jeopardizing the patient’s recovery.

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Below you will see the excess skin pulled back in the operating room to expose the separated abdominal muscles

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Here you can see the upper abdominal muscles which will be sewn together (as they have been on the lower part) to give the patient that “tight” abdomen she was wanting.

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In the operating room, you can see the breasts and tummy being worked on.

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Immediately after surgery in the operating room… with fuller, larger breasts and flat tummy. She had breast implants, minimal breast lift around the areola and extended abdominoplasty surgery.

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Posted in Abdominoplasty, Aerola Reduction, Benelli Lift, Breast Procedures, Extended Tummy tuck, Limited Lift (Benelli Lift), Mommy Makeover, Overfilled Saline Breast Implants, Revisionary Tummy Tuck


Extended Tummy Tuck Surgery

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This 45 year old patient from Temecula, California was interested in removing her excess skin and adipose tissue in her abdominal area.  She wanted a tummy tuck but her back also bothered her.  Her “muffin top” would hang over her pants and she wanted that removed as well.

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Dr. Pousti met with the patient and discussed the procedure in detail with the patient.  They decided to proceed with the extended abdominoplasty surgery.  In the operating room,  Dr. Pousti starts with the back portion and then proceeds with the front muscle repair and skin excision.

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The purple lines below show the abdominal muscles that have been separated.  These muscles will be repaired and sutured back together again to achieve the best result.  This muscle work will give the patient the tight tummy she is wanting.

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All of the excess skin and adipose tissue will be removed.

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Posted in Extended Tummy tuck


Mommy Makeover

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This 27-year old patient was unhappy with her “sagging” breasts and extra skin around her tummy. She met with Dr. Pousti in his La Jolla office to discuss her mommy makeover options.

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The patient has had 4 pregnancies, and is now ready to change her body. Dieting, exercising including sit up’s were not getting her the results she wanted. The patient was interested in tummy tuck surgery (abdominoplasty) to remove the excess skin and stretch marks around her abdomen and sides and also repair her abdominal wall muscles. Breast lifting surgery (mastopexy) to lift her breasts and breast implants to fill in breast volume.

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Her breasts are asymmetric (right breast larger then left breast) with the breast lift, Dr. Pousti plans to move the nipple and areola complex to a more pleasing position. The superfluous breast tissue and skin will be removed and to create the lifted “perky” look. Because the right breast is larger an anchor breast lift was necessary to achieve symmetry.

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Here you can see the dramatic difference between the two breasts.

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Measurements were carefully performed prior to surgery to achieve symmetry during the operation.

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Before back lipectomy

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Immediately after back lipectomy surgery with liposuction of back and flanks.

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After performing liposuction surgery, Dr. Pousti prepares to repair the separated abdominal wall muscle, these muscles are unfortunately separated during pregnancy and unable to “bounce back”.

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Saline breast implants were used and too 480cc in both breast with submuscular placement.

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Posted in Abdominoplasty, Breast Lift, Breast Lift with Implants, Extended Tummy tuck, Mommy Makeover


Extended Tummy Tuck Surgery

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This 22-year old patient was very unhappy with her post-baby body. She’s had only 1 pregnancy, and carried twins.

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She was interested in extended tummy tuck surgery to remove the excess skin and adipose (fat) tissue around her abdomen and sides.

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She also wanted liposuction surgery of the back and flank areas to contour her body for the “hour glass” shape.

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Dr. Pousti marks the patient’s separated abdomen muscles and prepares the repair them.

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Posted in Abdominoplasty, Extended Tummy tuck, Liposuction



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
Pousti Plastic Surgery of La Jolla
7301 Girard Avenue, Suite 203
La Jolla, California 92037
Phone: (858) 454-6888 or Email
Pousti Plastic Surgery of Temecula & Riverside
29995 Technology Drive, Suite 103
Temecula / Murrieta, CA 92563
Phone: (951) 501-9822 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. He has offices to serve patients in San Diego, La Jolla, Riverside, Inland Empire and Temecula.


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