By the time I turned 22 I knew I had to do something about them. I started researching different techniques to fix symmastia online and found that most of the before and after photos I was seeing on various websites were all attributed to Dr. Pousti. When I saw the great reviews people had left for him, I knew I wanted a consultation.

The difference between Dr. Pousti’s office and the office of my prior surgeon is like day and night. The girls at the front desk are all very nice and helpful, and Dr. Pousti is always on time for appointments. From our first meeting I knew that I wanted him to be the one to fix my symmastia. I think I visited his office three times in five days early on because I had so many questions and concerns regarding my procedure. Even though I had emailed him my questions, he invited me in to his office versus emailing me back to make sure I got a clear answer I could be satisfied with. Dr. Pousti’s confidence in his ability to fix my symmastia gave me confidence too. He was even able to schedule my surgery with very short notice, since it would be the only time my work and school schedule would allow for two weeks off until the following year. It’s amazing to me how he went out of his way time and time again to help me during the whole process.

The day of my surgery I was surprising calm. Aside from a little nervousness about how much pain I would be in after surgery, I wasn’t nervous at all about the procedure going well – I just knew it would. Most people thought I’d be a nervous wreck, seeing as how my last surgery ended up so horribly, but my faith in Dr. Pousti’s ability was quite strong. He just has this way about him that’s very reassuring and calming.

The surgical facility was also excellent. The nurses there were very kind and understanding, and did their best to make me feel comfortable. Right before I went under, I had both a nurse and Dr. Pousti holding my hands as the anesthesia went in, telling me not to worry. When I woke up, aside from the pain and grogginess that is to be expected, I felt great.

Interestingly, my pain after my symmastia revision surgery was far less than the pain I experienced after my initial augmentation. The day of my surgery I went home and was climbing stairs and watching TV, and the day after I went out to eat. In fact, the hardest part of my initial recovery was resisting the temptation to take off my tape/bandages to see what my new breasts looked like, but I figured if I could wait four years, I could wait a few more weeks.

When I was finally able to view the results of my surgery, I was absolutely amazed. Before where my breasts had touched and puffed up now laid a smooth, flat area of skin. The size of the space was perfect, and even though I was still somewhat swollen, I knew Dr. Pousti had listened to my wishes that I not have too much fullness on top. Seeing my results literally brought tears of happiness to my eyes, they were that great.

Now, about three months post-op, my breasts are softer, rounder, and more natural looking than ever. I have been wearing my “thong” bra religiously, and have resisted the urge to wear a normal bra or exercise. I was having a little trouble massaging the implants as often as Dr. Pousti told me to at first, so to ensure they stayed soft he put me on an anti-inflammatory medicine that has been helping tremendously. Also, the space between my implants is still flat and smooth, with no tenting or rippling to speak of.

I can now wear any type of top or bathing suit I like, and my breasts look great. I recently went bra shopping and for the first time, it was a pleasant experience. My life is becoming more in line with how normal 22 year olds live – I’m going out more and have more confidence, and I am no longer put in awkward situations where my old breasts would have held me back. This operation was truly life changing, and I cannot say enough about the amazing job Dr. Pousti and his staff have done for me.

If there’s one thought I want to leave people with, it’s that selecting the right surgeon is the most important decision you’ll ever make. Dr. Pousti is so talented at what he does, and shows genuine concern and compassion for his patients like I have not seen with any other doctor. His ability to fix what most other surgeons told me was difficult if not impossible to do shows what a true professional he really is. I only wish I had met him four years ago, but I’m more grateful than anyone can know to have him as my surgeon for my revision. Thank you Dr. Pousti and your wonderful staff for changing my life for the better.

Upon consultation the patient expressed to Dr. Pousti that she was unhappy with the size and shape of her breasts and also that she was experiencing a significant amount of pain due to her implants. Dr. Pousti explained to the patient that the pain was being caused by scar tissue that had formed around the breast implant. Capsular contracture is the formation of excessive scar tissue around the breast implant which causes the breast to feel firm and painful. Possible options were discussed with the patient and she felt confident that Dr. Pousti could achieve her breast revision goals.

Dr. Pousti and the patient meet several times prior to surgery and the procedure is discussed in detail. On the final meeting prior to surgery measurements of the breast are taken and markings are made. These markings are used as guidelines for incisions lines and help promote breast symmetry.

Using a small incision on the areola, the patient’s previous breast implants were removed along with the scar tissue. While removing the patient’s implants, it was discovered that her left breast implant was ruptured as well as encapsulated.

Scar Tissue Removed From Both Breasts

Sizer implants are placed into the breast pocket and filled with air until the patient’s goal size has been achieved. The patient is sat upright several times throughout the procedure to check for symmetry and fullness. Once a size has been chosen the sterile implant is selected and prepped for placement. In order to achieve this patients desired look silicone implants were recommended.

Before/After Breast Revision Surgery

For silicone gel breast augmentation surgery, Dr. Pousti uses the Keller Funnel method. This technique allows for a no contact method when placing the implant reducing the risk of contamination. The implant is easily placed into the breast pocket through a sterile funnel with a simple squeeze.

Dr. Pousti performed a capsulectomy to remove the scar tissue on both breasts along with a breast re-augmentation using 616cc silicone gel implants to achieve the her goals. The patient is very happy with the results of her revisionary breast surgery.

I wanted to express my sincere gratitude for the exceptional care and treatment provided by you and your team in connection with my Breast Augmentation – Remove and Replace procedure in February of this year.
Having spent greater than eights years working with renowned physicians surgeons throughout the United States as a medial malpractice defense attorney; it is my humble opinion that the skill level and degree of artistic perfection exhibited by you intra-operatively places you undoubtedly within the top tier of plastic surgeons. The trust and confidence that I intuitively felt pre-operatively were most certainly confirmed post-operatively by your polished work product, which incorporated, distinguished surgical and post-surgical techniques designed to maximize the aesthetic value of the breast augmentation. Likewise, the quality of care and concern exhibited by your team throughout this process further supports the conclusion that I am most pleased by the treatment referenced herein.
Based on the above, the decision to proceed under your care and guidance seems most obvious. Accordingly, please feel free to forward this correspondence, or to otherwise provide my contact information, to any prospective patients.

She stated in her initial email that she currently had 600cc implants and was interested in going much larger. Dr. Pousti reviewed her pictures and determined that she was a great candidate for saline overfilled implants. They discussed her options and the patient decided that Dr. Pousti was the right surgeon for her breast revision. The patient scheduled her surgery and flew from Australia to California to meet with him.

Dr. Pousti and the patient met prior to the procedure so that the revisionary breast surgery could be reviewed in detail. Measurements were taken of the chest to help aide in symmetry while performing the markings. The markings are used during the breast surgery as guidelines for incisions and to indicate where adjustments to the breast pockets are needed. The arrow markings illustrate where the patient desired more fullness. In order to achieve this Dr. Pousti will open up the breast pocket more towards the top and middle of the chest.

Once the patient is in the operating room her markings are rechecked and small incisions are made along the areola. The patients previous 600cc implants are removed and work on the breast pockets is started. After the breast pockets have been adjusted, sizer implants are placed. These sizer implants are filled with air until Dr. Pousti feel that he has met her size goals. The patient is then placed in an upright position and her look is compared to the pictures that she has brought in pre-operatively. The sizers are then removed and sterile saline implants are prepped.

800cc Saline implants overfilled to 1030ccs were used in each breast to achieve the look that the patient was interested in.

Immediately After Breast Revision in Operating Room

Email Sent from Patient of her Progress a Few Weeks Post Surgery

The patient is extrememly happy with her initial results and is very happy with her choice to go with Dr. Pousti.

Dr. Pousti examined the patient and suggested the patient have an implant exchange and breast lift to correct her current concerns. The patient decided to proceed with breast revision and breast lifting surgery. The patient and Dr. Pousti met prior to surgery to perform markings and discuss goal sizes. The patient brought in pictures that demonstrated what she was trying to achieve with her breast surgery. These pictures are hung on the wall in the operating room for Dr. Pousti to refer to during surgery.

The red arrows indicate where the patient would like to achieve fullness. The patient wanted to achieve “perkier” breasts with more cleavage, roundness, and volume.

A breast lift involves reshaping and rearranging of the breast tissue to appear more youthful and “perky”. Sizer implants are used in the operating room to determine sizing and to preview final results. The sizer implants are placed in the breast pocket deflated and then filled with air until the patient’s goal size has been achieved. Once sizing is determined, the patient is sat upright in the operating room, to check for symmetry and fullness. The breast incisions are temporarily closed using staples so Dr. Pousti can preview the potential final results. Adjustments are made if needed and final suturing is performed.

Dr. Pousti used 650cc silicone gel implants with a stage 3 lift to achieve the patient’s goals.

Immediately After Revisionary Breast Surgery in the Operating Room

The patient is very pleased with the results of her revisionary surgery with breast augmentation and lift.

I travelled from the Gold Coast, Australia just to see Dr Pousti. Hubby and I planned a wee bit of a holiday around the surgery..so it was all worth it making the trip.

I had contacted Pousti late last year by sending him some photos of myself and goal photos. I had 800cc silicone in my mind, but when he spoke with me over the phone he recommended that I don’t get fixated with a number, but concentrate on the look I am wanting to achieve. He suggested possibly getting 800-1000cc with an internal bra due to my bottoming out issue.

I had a pre-op consult a couple of days ago. After meeting with me, he felt 800cc silicone moderate plus and an internal bra would be ideal for the look I wanted to achieve.

I am now taking it easy back at our hotel and am on my second day of recovery. I have admit that it is more painful than my first BA, which I am guessing that it is from the internal bra. But overall it is nothing I cannot handle. I have a great husband who is taking good care of me

I would highly recommend Pousti and his team to anyone and everyone. Every single person I have dealt with was extremely lovely and professional. The whole process was simple and helped making the distance from Australia worth it.

I loved the fact that Dr Pousti didn’t over promise anything and was realistic with me about anything that could happen. As he says, “your breasts are like sisters, not twins” which is so true in every aspect.

I feel so happy with the results and stoked that I got everything that I wanted

The patient and Dr. Pousti communicated through emails and telephone calls and the patient felt extrememly confident in Dr. Pousti to achieve the best goals for her. She decided to fly to California to have her breast revision surgery performed. Upon examination, Dr. Pousti determined the patient breasts had formed scar tissue and became encapsulated. Encapsulated breasts occur when scar tissue forms around the implant and is also known as capsular contracture. This can often cause pain, discomfort, and distortion of the breasts. The patient and Dr. Pousti met the night prior to surgery to perform markings of her breast.

The purple arrow markings indicate where the patient would like to achieve more fullness and cleavage post-surgery, using larger implants.

Before Breast Revision

Markings of the areola were also done to determine where incisions would be made to perform the patient’s areola reduction. An areolatome, or cookie cutter instrument, is used during areola reduction procedures to determine sizing of the areola. The areolatome has a hole in the middle of the instrument to accommodate the nipple. The cookie cutter was pressed firmly onto the areola, leaving a circular imprint. After the incisions are made the patient’s previous breast implants are taken out and removal of scar tissue is performed.

Scar Tissue Removed from Breasts in Operating Room

To achieve the patient’s goals, 800cc Saline implants overfilled to 850cc were used in both breasts. The patient is extremely happy with the results of her revisionary breast surgery.

Immediately After Breast Revision in Operating Room.