My 1st breast augmentation surgery was performed overseas 25 years ago! I had silicone implants positioned over the muscle. I developed capsular contracture and for that reason, together with the age of the implants, felt that it was time for revision surgery.
I did so much research on the subject, I felt like I had earned a degree on the subject! Armed with this knowledge, I narrowed down my choice of surgeons to 3. Due to the amount of experience Dr Pousti had in revision surgery, together with the glowing reviews about his personal demeanor, skill and professionalism, Dr Pousti was hard to fault and in the end, I made only one consult appoint with Dr P and that meeting was enough to make me comfortable enough to go ahead with the surgery.
I am now 12 months post op and am so happy with my results. I was terrified that the end result would be bigger than I wanted, but he was exactly spot on with my desired size.
I drove 6 hours for each appointment to see Dr Pousti but it was definitely worth it. He is such a caring, gentle doctor and must admit that you can’t help but fall a little bit in love with him. Hopefully I won’t develop capsular contracture again but I know if I do, I’ll be back to see Dr P for any future surgeries.
Thank you to all at Pousti Plastic Surgery for your expertise and professionalism always!

This 32 year old from La Mirada, California  (Palm Springs Area) was interested in revisionary breast surgery after suffering capsular contracture of her left breast. Capsular contracture is when the breast produces scar tissue that surrounds and grasps onto the implant often making the breast firm and painful. After reading about several San Diego Plastic and Cosmetic surgeons on a blog site, she noticed many patient’s discussing Dr. Tom Pousti from San Diego/Riverside County. She was overly impressed with all of the reviews from Dr. Pousti’s previous patients.

Upon examination, Dr. Pousti confirmed that the patient had capsulectomy, an excessive amount of scar tissue was formed, causing asymmetry, pain, and distortion. The patient decided to continue with breast re-augmentation surgery after meeting with Dr. Pousti.

Before Breast Revision

Dr. Pousti met with the patient prior to her procedure to take measurements, map out markings, and discuss implant size. The patient decided she wanted overfilled saline implants to achieve a much more fuller and rounder look.

During Breast Revision

Capsulectomy revision surgery involves removing the patient’s previous implants, as well as the scar tissue that had formed around her left breast implant. Once this tissue has been removed, new implants are placed below the muscle.

After Breast Revision

Dr. Pousti used smooth round moderate plus profile saline implants overfilled to 1030cc on each breast to achieve the patient’s goals.

The patient is now 3 days post-op and is already very satisfied with her results.

This 22 year old patient from San Diego, California had breast augmentation surgery performed by a previous surgeon and was left with unsatisfactory results. The patient was not happy with the overall appearance of her breasts but the breast shape bothered her the most. She did not feel comfortable returning to her previous surgeon and knew that she would have to do research to find a surgeon that was experienced with revisionary breast surgery. During her search she came across Dr. Pousti several times and was very impressed with the vast amount of experience he had with breast revision procedures.

Upon examination it was apparent to Dr. Pousti that the patient had a severe case of ‘Symmastia’. Symmastia occurs when the skin near the cleavage area separates from the sternum; causing the implants to be malpositioned medially. This can cause the breasts to form a ‘bread-loaf‘ appearance.

The patient and Dr. Pousti meet several times prior to the revisionary breast surgery to discuss options and go over the procedure in detail. In this patient’s case the best option was to go with symmastia repair and an implant exchange. The first step of this surgery is to take measurements of the patients chest and mark the areas where correction is needed.

When the patient is in the operating room she is placed in an upright position and markings are re-checked. If any adjustments are needed they are done at this time. The red area indicates where the symmastia repair will need to be done.

The patient’s current breast implants are taken out through a small incision along the areola. To avoid additional scaring the previous incisions were re-used. Once the implants are removed Dr. Pousti begins work on the ‘breast pocket’. A breast pocket is an open pocket created under the muscle where the breast implants sits.

During symmastia repair Dr. Pousti uses internal sutures to re-attach the skin to the sternum in the center of the patient’s chest. Sizers are then used to determine the size of the implant Dr. Pousti will need to use in order to achieve the patient’s desired look.

300cc Silicone Gel Implants were used in both breast to meet her goals.

As you can see when the patient is in a lying down position the symmastia correction has improved the appearance of the chest and the patient no longer has ‘tenting‘ present.

After the procedure is completed, bolster dressings are applied. The dressings help add support to the internal sutures and help ensure that implant malplacement does not reoccur.

A “thong bra” is then given to patient to wear post surgery and is used to stabilize the area after symmastia reconstruction. This will allow the sutured area between the breasts to heal properly without excessive pressure being applied.

This 38 year old from Chula Vista, California was interested in revisionary breast surgery after being left unsatisfied with her breast augmentation results performed by a previous surgeon. She was extrememly cautious about having another surgery performed and not being happy with her results a second time. She decided it was a good idea to research more and find a board certified plastic surgeon with experience. The patient had heard about double board certified Dr. Pousti from numerous people and decided to research about him and his practice. She was surprised by the amount of information regarding revisionary breast surgery displayed throughout Dr. Pousti’s many websites.

During her consultation, she was able to meet and talk with other patient’s of Dr. Pousti’s who underwent revisionary breast surgery. She couldn’t believe the phenomenal results Dr. Pousti was able to achieve for his patients and how happy they were with their surgical results. The patient’s fears were diminished and she completely trusted Dr. Pousti to perform her surgery. Upon examination, Dr. Pousti felt the patient had accumulated scar tissue that needed to removed and the patient would need internal sutures and an implant exchange to correct her current concerns. Dr. Pousti carefully performed markings and measurements to achieve symmetry and to correct the current problems. During this time, he also discussed the procedure to the patient from the start of the surgery to her recovery.

The red area indicates where internal sutures will be used to correct the patient’s current implant position.

Dr. Pousti met with the patient again the morning of surgery to reinforce markings and to discuss the procedure with the patient again. He also will answer any questions the patient may have and will try to make the patient feel as comfortable as possible.

Below you can see when the patient is lying flat, her implants will fall to the sides. Internal sutures will be used on the outer portion of the patient’s breasts to correct the malplacement issue.

In the operating room, Dr. Pousti uses temporary sizer implants. This allows him to adjust the implant in size until he reaches the patient’s desired look. Once this has been achieved, the sizer implant is removed, and the permanent implant is placed.

Below you can see, Dr. Pousti has removed the sizer implant and will now prepare and administer the patient’s permanent implant.

After the implants and scar tissue have been removed, Dr. Pousti will tighten the breast pocket using internal sutures. Capsulorrhaphy, the use of internal sutures, will correct the breast pocket preventing the implants from falling to the side and will restrict the patient’s breast implants from falling to the side.

490cc Silicone Gel Implants were used in the patient’s breast o give her the look she wanted. She is extremely happy with her breast revision results.

Dr. Pousti is the most talented, professional, warm and attentive doctor in practice. I was traumatized by the work of another, traveled all over California to undergo revisions and ended up in the skilled hands of Dr. Pousti who made me look better than I did before my first surgery. Thus, Dr. Pousti is truly my hero. Further, to say Dr. Pousti’s staff is amazing is an understatement! I would highly recommend everyone to Dr. Pousti. I already have! I will forever be thankful to him.

This 32 year old from La Mirada, California  (Palm Springs Area) was interested in revisionary breast surgery after suffering capsular contracture of her left breast. Capsular contracture is when the breast produces scar tissue that surrounds and grasps onto the implant often making the breast firm and painful. After reading about several San Diego Plastic and Cosmetic surgeons on a blog site, she noticed many patient’s discussing Dr. Tom Pousti from San Diego/Riverside County. She was overly impressed with all of the reviews from Dr. Pousti’s previous patients, but most importantly his revisionary breast patient’s and decided to schedule a consultation with him in his La Mesa office.

While examining the patient, it was apparent that the patient was experiencing an encapsulated implant on the left breast. The encapsulation was causing the patient pain and extreme discomfort.

Before Breast Revision

Dr. Pousti met with the patient prior to her procedure to take measurements, map out markings, and discuss implant size. The patient decided she wanted overfilled saline implants to achieve a much more fuller and rounder look.

During Breast Revision

Capsulectomy revision surgery involves removing the patient’s previous implants, as well as the scar tissue that had formed around her left breast implant. Once this tissue has been removed, new implants are placed below the muscle.

After Breast Revision

Dr. Pousti used smooth round moderate plus profile saline implants overfilled to 1030cc on each breast.

The patient is now 3 days post-op and is already very satisfied with her results.

Thank you for all, I couldn’t have a better result. I believe you are one of the best doctors in the world in the sector of breast surgery. Best wishes

This 22 year old from Santa Clara, California (Northern California) was interested in revisionary breast surgery after being left unsatisfied with her results from her breast augmentation with a previous surgeon due to asymmetry and bottoming out . After having a bad experience with her prior breast surgery, she understood the importance of choosing an experienced and qualified surgeon. She researched online for a board certified plastic surgeon who had experience with breast augmentation revision. She found Dr. Pousti, a double board certified plastic and reconstructive surgeon, and after reviewing 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 and are double and triple checked before surgery.

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

Dr. Pousti uses the same incisions from the patient’s previous breast surgery to avoid any further scarring 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, also known as an internal bra, was performed.

Before Breast Revision

When the patient is laying flat, the breasts would fall to the side prior to surgery.

After Breast Revision

When the patient is laying flat, her breasts now remain in the center of her chest with support from the internal sutures.

Bolster dressings are applied for additional support to the sutured breast pocket until the patient is completely healed about 8 weeks post-surgery.

The patient is still very fresh from her surgery, but is extrememly pleased with the intial results from her breast revision procedure.

Unfortunately I had to have a revision only 10 months after my initial augmentation because only 4 months after my first surgery I had apparently encapsulated on both sides.  My new surgeon found no scar tissue, no encapsulation, but he did find that the pockets were not big enough, even for my smaller implants, and the type and shape of the implants were wrong.  He fixed everything, I look great and now 7 months post revision my breasts are still soft!! Everything was handled with professionalism, grace and compassion.