This 22 year old from Northern California was interested in revisionary breast surgery. The patient was extrememly unsatisfied with the outcome of her breast augmentation with a previous surgeon due to asymmetry and bottoming out . After realizing how important choosing her surgeon is, she researched online for a board certified plastic surgeon. She found Dr. Pousti, a double board certified plastic surgeon who had a lot of experience with breast augmentation revision. She reviewed his website containing “before” and “after” photos of revisionary patients, she decided to schedule a consultation to meet with Dr. Pousti.

At her consultation, she was able to meet with patients of Dr. Pousti’s, who underwent a similar surgery and talk to them in private about their experience.  Talking with Dr. Pousti’s patients in person and viewing their results showed the patient how confident Dr. Pousti is with his work. With careful thought, the patient felt comfortable proceeding to surgery with Dr. Pousti. The patient met with Dr. Pousti again to discuss the surgical plan tailored to meet her goals. Markings were meticulously performed with accuracy.

To correct the patient’s asymmetry and bottoming out Dr. Pousti felt revisionary breast surgery including internal sutures (internal bra) would be in the patient’s best interest. The capsulorrhaphy procedure, also called internal sutures, consists of pocket correction, where a portion of the breast pocket is closed, which will correct displacement of the implant, the cause of asymmetry and bottoming out.

Before Breast Revision

Patient had “bottoming out” present on her right breast, creating asymmetry.

Removal of The Original Implants

One incision was made on each breast and the original breast implants were removed and internal sutures were used to repair the breast pocket and to create the new breast fold. The old implants were replaced with silicone gel implants placed below the muscle.

After Breast Revision

Capsulorrhaphy was performed.

Before Breast Revision

When the patient is laying flat, the breasts will fall to the side.

After Breast Revision

When the patient is laying flat, her breasts now remain in the center of her chest.

Bolster dressings are applied for additional support and protection to the sutured breast pocket.

The patient is extrememly pleased with the results of her surgery.

First and foremost I want to thank Dr. Pousti and his staff for such a positive experience.  Prior to meeting Dr. Pousti I had undergone two breast augmentation surgeries.  I had my first in 2005 and my second in 2007. In 2007 I maxed out what was the traditional “conservative” plastic surgeon’s recommendation with 800cc silicone implants. I loved the results but I went on to have two amazing daughters which I breastfed back to back in 2010 and 2011. My breasts needed some work.  They weren’t as perky anymore and I had lost some of my own breast tissue from nursing. I also had lateral displacement of my implants. Basically, when I laid on my back my breasts went into my armpits which left quite a considerable space in my cleavage area. I also knew I wanted to go bigger. Here is when the research started-I met with my former plastic surgeon and his opinion was that I needed a full anchor lift and all the scarring that came with that. I felt it was overkill and was saddened by the recommendation but I booked my surgery trusting his advice. After more thought, I decided to look into the option of over filled saline implants and maybe a little “pocket tightening”.  I first learned about Dr. Pousti from his AMAZING website.  The testimonials and photos said it all. I knew I needed to rethink my decision and have a phone consultation with him. I emailed photos (frontal and side) and he got back to me via telephone very promptly. To my excitement he told me he thought I didn’t need a lift. He also was willing to go as big as was safe for my body. I canceled my other surgery and put down my deposit for my surgery in San Diego. The website and staff had wonderful recommendations on which hotels they recommended their patients stay at and the hotels even offered a discount for being his patient. I was also given the name of a great after surgery recovery nurse who went on to do a phenomenal job of taking care of me post op for the first 24 hours. When I met Dr. Pousti for my pre op the day before surgery I instantly knew I had made the right decision to have my surgery performed by him. He is such a skilled, caring and kind person. At my pre op he recommended I have internal sutures placed to correct my implant displacement and promised he would take great care of me. I am absolutely insanely in LOVE with my new breasts. I would never trust my body to another plastic surgeon after meeting Dr. Pousti.  As a former model, I can tell you that I almost idolize the man for giving me back the breasts I had before having my children. I would recommend Dr. Pousti to anyone who wants the job done right. Flying out for surgery, especially alone, can be a scary thought but it is such a worthy investment. The moment you walk into his office-no matter the distance you have traveled-you will feel at home. Thank you Dr. Pousti for changing my body and my life.

One of our very satisfied patients!

It has been a year since my breast revision surgery and I want to thank Dr. Pousti and his great staff for the expertise and professional treatment I received.  Dr. Pousti is wonderful.  He has certainly met and gone above and beyond my expectations of a qualified plastic surgeon. This has been my third surgery and third plastic surgeon.  The first surgeon was a recommendation from a friend.  She was happy with her results and the cost was a little cheaper.  The office staff was nice and everything seemed fine.  After my breast augmentation surgery I could tell as the months went by that something was not quit right.  By six months I could see that my breasts were sliding down from the implants.  I should have had a breast lift done and I feel that the Dr. should have informed me of that.  I didn’t feel comfortable going back to him for a revision.  I researched a second Dr. and he had GREAT reviews and after a year from the first I had a revision done.  He was highly qualified and one of his offices was in “Beverly Hills”.  He was much more expensive.  I felt confident in him and his staff.  Well, it is too long of a story so I will just say that there were things that went wrong from the beginning before the surgery was even done.  Some miscommunications with a nurse and a few other things that led to a very unpleasant post op. Again, after the surgery I could tell something was wrong.  As the months went by one of my breasts continued to bottom out.  I still felt that the surgeon was highly skilled and could have fixed the problem but his attitude changed and he didn’t want to acknowledge all of my concerns.  This caused me great depression.  I had a revision date scheduled but both my husband and I felt I should look again at my options and search for another surgeon.  I got on the computer and found Dr. Pousti on a cite recommending plastic surgeons.  (My second Dr. was on there as well.)    He seemed special and after the first visit with him I knew he was.  Dr. Pousti acknowledged my concerns and did an amazing job of revising my breasts.  I wish I could have found Dr. Pousti the first time around.

This 49 year old patient from Encinitas, California was interested in revisionary breast surgery after being unsatisfied with the outcome from her original breast augmentation. The patient had her breast augmentation performed in 2010 and did not feel comfortable returning to her previous surgeon for her breast implant revision. She was referred by a good friend of her’s and a previous patient of Dr. Pousti’s to Pousti Plastic Surgery and immediately felt comfortable and knew Dr. Pousti was the right surgeon for her breast revision surgery.

During examination,  it was apparent that the patient’s breast implants “fall into her armpits” when she lies down.  She wanted larger implants for more fullness on top as well as improvement of the placement of the breast implants on her chest wall.

The breast augmentation revision procedure was reviewed again with the patient in detail the morning of surgery. Markings and measurements were made as guidelines for the revision. The red arrows indicate where the patient wishes to achieve more fullness.

In the operating room after the breast implants were removed.

Immediately after pocket correction and replacement with new, larger, silicone gel breast implants.

Below, you can see how the implants went “off to the side” before her breast augmentation revision.

With the aide of the internal bra, is it apparent that the implants are in the proper position and significant improvement has been made regarding breast implant position.

The patient is still healing, but is very impressed with her breast revision surgery.

This 31 year old patient from San Diego, California had a previous breast augmentation performed and was not happy with the shape or size of her breasts. After searching on the web for a surgeon experienced with revisionary breast surgery she came across Dr. Pousti’s website and was impressed with the amount of information he provided regarding breast revision surgery. After meeting with Dr. Pousti, it was apparent that in order to achieve the patient’s goals, she must remove her previous breast implants, have breast pocket correction and replace the old implants with new implants.

Markings of the revisionary breast surgery were performed prior to surgery and rechecked several times to ensure . These markings are used as guidelines for incisions and help with adjustments that need to be made for the breast pockets.

The patient’s left breast pocket was too wide allowing it to ‘fall outward‘. In order to fix this, Dr. Pousti used internal sutures on the side of the patients breast to close that portion of the pocket.

After pocket correction is performed the sterile implants are set in place. To meet this patient’s size goals and achieve symmetry a 570cc saline implant was used in the patient’s right breast and a 530 cc saline implant was used in her left breast.

Immediately After Revisionary Surgery

The patient is post op removal of old implants, pocket correction and replacement of saline breast implants and loves her results.

For many patients, plastic surgery is a life-changing experience, both physically and mentally. Many people considering surgery to improve their looks do not realize that they may also experience some emotional ups and downs. There are a number of positive psychological benefits that contribute to the patient’s boost in confidence and self-esteem. However, some adverse emotional side effects may also be involved, such as depression and anxiety.

Cosmetic surgery can be very exciting, yet, frustrating at the same time. Some may find the process a pleasant one, while others find it stressful. People find it difficult to find a Board Certified Plastic Surgeon they are comfortable with and who they feel they can trust with this major change. Anxiety may occur prior to the surgery and during recovery while patients try to patiently wait for their final results. Post-surgical depression is common, especially among patients with personality disorders, relationship issues, and lacking confidence.

Before undergoing any cosmetic procedure, it is important to keep a positive attitude. Having realistic expectations for your plastic surgery experience is crucial to having a positive mindset later. The purpose of plastic surgery is to improve a specific problem area of your body. There is no guarantee the results of your surgery will change your life.

Discussing your expectations and goals with your surgeon will ensure the best results possible. This communication allows your doctor to help achieve your goals. Make sure you discuss what your expectations are with your surgeon. It is best to express all your concerns prior to the procedure so that he/she may address them to help ease the process. A Board Certified Surgeon will discuss the best and safest option for your specific case.

It is in your best interest to discuss your medical history with your doctor. Cosmetic surgery can either be minor or invasive and in any case, your surgeon should be aware of all medical conditions that may affect your surgery or healing.

Once you decide on a plastic surgeon and the planned procedure, it is vital for you to prepare for your recovery period. It is best that you are aware of what to expect after surgery and understand the pre-op and post-op instructions to ensure the best result possible. For example, swelling and bruising is a normal part of the healing process, pain and discomfort can be managed with medications, physical activity should be limited to promote healing and rest, and it is essential for you to have a good support system.

Remember that all of these contributing factors to post-surgical depression or anxiety is temporary. With tincture of time, the incisions will heal and your results will improve. When times get tough, communicate your concerns during your follow-ups with your doctor and keep the end result in mind.

This 40 year old patient from Circleville, Utah was interested in breast revisionary surgery. She was unhappy with her previous breast augmentation surgery performed in 1998 by a different surgeon. While doing some researching online for a breast revision surgeon, the patient came across Dr. Pousti’s website.  Being from out of state the patient did an extensive amount of research before setting up an email consultation with Dr. Pousti. The patient actually flew out to meet with Dr. Pousti. She was so impressed by his knowledge and understanding of what she wanted that she decided to decided to fly in to San Diego.

While meeting with the doctor the patient explained “the look “she wanted. The patient did not like how her right breast implant “fell into her armpit” and so Dr. Pousti explained the need to use internal sutures for her right breast (capsulorrhaphy) to prevent recurring dislocation. The patient also decided to replace her saline breast implants with silicone gel implants. The patient was pleased with Dr. Pousti that she scheduled her  breast revisionary surgery.

Prior to surgery, markings are made to explain in full detail what Dr. Pousti will be doing during the breast augmentation revision surgery.  The permanent sutures will be placed so that they act like an “internal bra” holding the implants in the correct position.

The red arrows below indicate where fullness of the breasts will take place.

Saline Filled Implants Removed

Sizers are placed during the procedure to achieve the patient’s goals. The patient is sat “upright” several times through out the procedure so that Dr. Pousti can adjust the volume, the pocket and try to achieve as much symmetry as possible.

Immediately After Breast Revisionary Surgery

To achieve the patients goal look, Dr. Pousti placed 533cc silicone gel implants for both the right and the left breasts. The patient is 2 months post-op surgery and extremely happy with her results.