Cases
Symmastia Repair with the use of AlloDermThis 36-year old out-of-town patient was unhappy with the appearance of her breasts and was interested in revisionary breast surgery. The patient is status post breast augmentation surgery in 2003 and revisionary breast surgery in 2003 and again in 2009 and was not pleased with her results.
Due to symmastia and rippling, the patient was very unhappy with the results of her surgery and she experienced pain on the sternum area.
After researching for a Board Certified Plastic and Reconstructive Surgeon who is experienced in symmastia repair to perform her breast revision surgery she came across Dr. Pousti and was impressed with his experience.
Symmastia – commonly referred to as “bread loafing” or “uni-boob”, occurs when two implants touch one another in the center of the chest. If the horizontal muscle that is connected to the sternum and goes across the implant is cut during surgery, then the implant can move toward the middle of the chest. Symmastia results from overly aggressive attempts to alter chestwall anatomy trying to increase cleavage in patients. This outcome is made worse by use of larger implants in thin patients. The “red marks” above are where Dr. Pousti will be placing the pieces of AlloGraft to help support the internal sutures.
Her previous implants were removed, and internal sutures were used to establish the “new” breast pocket.
AlloDerm was also used to improve the rippling by putting an extra layer of coverage between the implant and the skin due to the patient’s thin skin and minimal breast tissue.
The internal sutures create an “internal bra” to hold the new implants in it’s new position.
With the symmastia repair, improved appearance of her breasts by creating separation in her cleavage.
700cc silicone-filled breast implants were used in both breasts with submuscular placement.
Updated pictures will be soon posted, sent via e-mail by the patient.
Breast Reconstruction Surgery – AlloGraft
This 31-year old patient from Coronado, California had breast augmentation surgery in 2008, performed by another surgeon. Due to the results of her right breast, the patient had revisionary breast surgery with the same surgeon with no success. The patient then moved to San Diego and found Dr. Pousti.
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.
Implant Deflation – Revision Breast Surgery
This 34-year old patient from Riverside, California researched for an experienced Board Certified Plastic and Reconstructive Surgeon to perform her revisionary breast surgery . Due to the results of her previous breast augmentation surgery performed in 2005 by another surgeon.
The patient was interested in removing her previous breast implants and replacing with new extra large implants.
Before surgery
Immediately after surgery.
In order to achieve the look that she desired, Dr. Pousti overfilled her saline implants to achieve the extra large look.
Before surgery, The patient came in with deflation of the right breast.
With markings you can see where the patient wanted fullness.
The saline implants were filled to 1100cc in both breasts placed submuscularly.
She is very happy with her new larger breasts.
Breast Implant Revision Surgery
This 42-year old patient previously had breast augmentation surgery in 1999, performed by another surgeon and was unhappy with the size and placement of her breast implants. She an online research for an experienced revisionary breast surgeon.
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.
Implant Deflation – Revision Breast Surgery
This 34-year old patient from Riverside, California was very unhappy with the results of her previous breast surgery, which was performed by another surgeon. She had breast augmentation surgery in 2005, due to her right breast implant deflating, the patient researched for a revisionary breast surgeon.
The patient wanted to remove her previous implants and replace with new larger implants with overfill.
Before surgery
Immediately after surgery.
The patient wanted as much fullness and cleavage as possible. Dr. Pousti removed her previous implants and replaced them with new extra large saline implants.
Before surgery, The patient came in with deflation of the right breast.
With markings you can see where the patient wanted fullness.
In order to achieve her desired look, the saline implants were filled to 1100cc in both breasts placed submuscularly.
She is very happy with her new larger breasts.
Implant Exchange with AlloGraft
This 21-year old patient was unhappy with her previous breast surgery (performed by another surgeon). She wanted revisionary breast surgery to correct the mal-position of her right breast and to remove her saline breast implants and replace them with larger breast implants.
The patient is from Philadelphia and flew into San Diego, California to have breast revision surgery performed by Dr. Pousti.
You can see the mal-position of the right breast; the breasts were asymmetric and she was unhappy with the appearance. She wanted more cleavage, fullness and breast projection.
In order to repair and correct the mal-position of her left breast, internal sutures were used and placed to position the breast more medially (middle), then AlloGraft (a surgical graft tissue) to strengthen the repaired areas.
Here you can see the placement of the AlloGraft tissue.
The patient without implants, Allograft and internal sutures in place.
New saline breast implants were placed submuscularly and filled too 960cc in both breasts.
- Before side profile
She is extremely happy with her results and sends updates and pictures via e-mail daily.
Revision of Implants Surgery
This 46-year old patient from Escondido, California is post breast augmentation surgery in 2000, performed by another surgeon. She wanted revisionary breast surgery to go larger in breast size.
After 10-years post-op breast surgery, the patient decided to significantly increase her breast size and also replace her current implants with silicone gel breast implants.
While performing markings, Dr. Pousti sits the patient in the upright and laying down position to ensure symmetry in both positions for the patients and achieve the best look for the patient.
With the previous implants removed, Dr. Pousti creates new breast pockets and space for cleavage and fullness for the new larger silicone gel implants.
Moderate plus profile 800cc silicone gel implants were placed submuscularly in both breasts, made by Mentor Corporation.
Extra Large Breast Implants – Overfilled Implants
This 36-year old patient Imperial County in California previously had saline breast implants filled to 650cc in both breasts and was unhappy with the shape and size of her breasts. She wanted extra large breast implants.
Her friend told her about Dr. Pousti and so she decided to meet with Dr. Pousti in his San Diego office. She discussed in detail what she would like to achieve with breast revision surgery and after much discussion, she knew he was the best surgeon for her.
The patient wanted to significantly increase in fullness, and she was unhappy with the previous size and position. Dr. Pousti will be placing internal sutures on her sides (laterally) for more projection medially.
Before surgery
After the internal sutures are placed, and temporary sizers are filled, Dr. Pousti sits the patient in the upright position to check for the patient’s desired shape and size.
Immediately after surgery, fullness and volume is achieved with saline breast implants filled to 1230cc in both breasts.
The patient is extremely happy with her results and is now 2-weeks post-op surgery.
Implant Exchange Surgery
This 34-year old patient from Chula Vista, California (South San Diego County) had breast augmentation surgery with a limited breast lift (mastopexy) on the left breast in 2009.
The patient before breast augmentation surgery.
The patient 6-months post-op surgery.
The patient was extremely happy with her surgery and knew that Dr. Pousti would achieve exactly what she wanted. After a couple years, the patient wanted to “Go Bigger”.
When patient decided that she wanted to have revisionary breast surgery with extra large implants, she knew she wanted Dr. Pousti to perform her surgery.
The patient previously had saline breast implants filled to 400cc in the right breast and 380cc in the left breast.
In order to achieve her desired look, Dr. Pousti removed her previous saline implants and were replaced with new saline implants then filled to 600cc in both breasts. The patient is very happy with her new body proportions and is now 3-weeks post-op surgery. The patient will continue to settle over time.
Breast Revision Surgery – Encapsulation
This 62-year old patient from Escondido, California (North San Diego County) had (subglandular) breast augmentation surgery with silicone implants in the 1980’s performed by another surgeon.The patient had significant encapsulation in both breasts and experienced breast pain in her right breast.
The patient was interested in revisionary breast surgery for many years and decided to proceed with surgery after meeting Dr. Pousti.
Due to encapsulation, the patient was unhappy with the results of her surgery. The patient described to Dr. Pousti that she just wanted to look natural and have some fullness and cleavage. Markings were performed the morning of surgery, and the planned procedure was drawn out in detail.
Breast capsule removed from patient.
Dr. Pousti removed the patient’s 30-year-old silicone breast implants and performed capsulectomy in both breasts.
421cc silicone-GEL breast implants were used to replaced the previous implants with submuscular placement (implants placed under the muscle).