This 21- year old patient from Bonita, California had her previous breast augmentation performed by a plastic surgeon in Tijuana, Mexico almost 2 years ago. This surgeon, who was recommended to her by a friend did not perform standard procedures and placed drains in the patient’s breasts after her procedure. Only after 2 months of her surgery, the patient noticed that she had developed symmastia and was very unhappy with her results and especially the “uniboob” look (the implants were touching down the mid-line).  Notice that the patient no longer has “cleavage”. The patient’s nipple-areola looked displaced to each side. The implants have also “bottomed out”.

The patient was extremely upset about the results and worried about having revisionary surgery to correct her symmastia. She wanted to make sure that this time she went to a board certified Plastic Surgeon who scecialized in symmastia repair and revisionary surgery.

Another friend recommeded Double Board Certified Plastic Surgeon, Dr. Tom Pousti in San Diego, so she met with him for a consultation. She was very impressed by the amount of time that Dr. Pousti spent with her explaining how the revisionary surgery would proceed. Dr. Pousti explained that he uses an “internal suture” technique therefore leaving no additional scars on the outside of the breasts. She was shown pictures of other patients who also had symmastia repair performed by Dr. Pousti.

This patient proceeded with revisionary surgery 2 months after her first consultation with San Diego plastic surgeon, Dr. Tom Pousti. Her surgery took about 2 hours with a lot of time and care taken to make sure that we achieved her goals. After her current implants were removed, Dr. Pousti placed internal sutures to reattach the skin to the chest wall and then placed her new implants under the pectoralis muscle. She has smooth, round, saline filled implants placed under the muscle. She has a 390cc saline implant placed on the right and a 420cc saline implant placed on the left.

During the recovery period, this patient had to wear a special bra called a “thong bra” to help stabilize the area in between the implants where the internal sutures were placed. After taking care to avoid the heavy lifting for the first 4-6 weeks, her recovery proceeded smoothly and she is very happy with her results.

The first week, you will see bruising and swelling due to the work performed creating the “pocket” for the implant. The internal sutures connect the skin to the sternal wall therefore not allowing the implants to “communicate” with each other. Performing the internal suture technique allows the patient to achieve the results with no additional scarring on the outside of the breasts. Notice the development of a cleavage area, correct positioning of the nipple-areola complexes and correction of the “bottoming out” condition.

This 25-year old patient from Palm Desert, California had her first breast augmentation performed in Mexico. A few months after having her breast augmentation, the patient noticed that she had developed symmastia (the implants were touching down the mid-line) and her implants were “bottoming-out”. She had a “uni-boob” as some would call it. Notice that the patient no longer has “cleavage”. The patient’s nipple-areola look displaced to each side.

The patient was extremely upset about the results and worried about having revisionary surgery to correct her symmastia. She wanted to make sure that this time she went to a board certified Plastic Surgeon who had experience in symmastia repair.

She found San Diego Plastic Surgeon, Dr. Tom Pousti through her sister and came in for a consultation. She was impressed by the amount of time that Dr. Pousti spent with her explaining how the revisionary surgery would proceed. Dr. Pousti explained that he uses an “internal suture” technique therefore leaving no additional scars on the outside of the breasts. She was shown pictures of other patients who also had symmastia repair performed by Dr. Pousti.

Although she lived in Palm Desert, she felt very comfortable with Dr. Pousti and traveled to have this procedure performed. This patient proceeded with revisionary surgery with San Diego plastic surgeon, Dr. Tom Pousti.

She had bottoming out of both breast implants and a wide scar on the right side. The encapsulation on the left was worse than the right side. The areola were laterally displaced on both sides. The patient experienced numbness of the left nipple-areola complex.

Dr. Pousti took his time with the “markings” that were performed the day before surgery. After careful measurements, the markings are performed and reviewed with the patient.

Her surgery took about 2 hours with a lot of time and care taken to make sure that we achieved her goals. After her current implants were removed, Dr. Pousti placed internal sutures to reattach the skin to the chest wall and then placed her new implants under the pectoralis muscle. To achieve the results that the patient wanted, Dr. Pousti used silicone gel implants. The right side had a 533cc silicone gel implant placed under the muscle and the left side had a 575cc silicone gel implant placed under the muscle.

This 26-year old patient came in to see Dr. Pousti regarding revisionary breast surgery. She had previously had her breast augmentation surgery performed by another surgeon but was very unhappy with her results. The other surgeon had placed saline implants on top of the muscle (sub-glandular positioning of the implants) and therefore the patient had ALOT of rippling. She could feel the implants and did not like the way she looked.

She found Dr. Pousti on the internet and saw that he performs revisionary breast surgery and “his results were beautiful”. After coming in for multiple consultations, she felt very comfortable proceeding with revisionary breast augmentation surgery. Dr. Pousti informed the patient that silicone gel breast implants have now become FDA approved and in her case, may give her the results that she is striving for. She wanted Dr.Pousti to enhance the size of her breasts and achieve more cleavage and fullness while still maintaining the natural look.

Silicone gel implants give more “natural” feeling breasts especially for those who have minimal breast tissue. Silicone gel implants also produce less “rippling” than saline filled implants. The implants are placed sub-muscular (under the pectoralis muscle) but the muscle does not completely cover the implant and so if a patient has little breast tissue, she may feel the implant ripple on the outer or inner edges.

She is now only one month after revisionary breast augmentation surgery. Her subglandular (over the muscle) saline breast implants were removed and replaced with silicone gel breast implants placed in the sub-muscular (under the muscle) position.

She is extremely thankful to Dr. Pousti for giving her the results that she had always wanted.

This 23-year old San Diego patient was very unhappy with the results of her previous breast surgeries (performed by a different surgeon). She had immediate problems after her first operation and a second revisionary surgery did not fix the situation.

This patient decided to search the internet for an “expert” to help her achieve her goals. She had symmastia (the implants wer touching down the middle of her chest) — sometimes called “uni-boob”. She also had “bottoming out” of the implants. Symmastia – commonly referred to as “breadloafing” 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, and is a problem for implants over or under the muscle, though submuscular implant placement allows the muscle to provide some softening of the transition to the cleavage area from the augmented breast mound.

She was excited to find Dr. Pousti and meet with him to discuss her options. She immediately decided that he was the best surgeon for her and decided to proceed with surgery.

The night before her surgery, “markings” were done. Dr. Pousti took his time and drew out exactly what would be performed in the operating room the next day to correct her symmastia and the bottoming out of her implants. The patient and the doctor discussed the differences between silicone gel breast implants and saline filled breast implants and they decided to proceed with using silicone gel implants.

In the operating room, Dr. Pousti and his staff took time to improve her look and get the results that this patient had been wanting.

After the surgery, the patient had to wear a protective and supportive garment to support the work that had been performed to separate the implants. All sutures are internal — no exteral sutures (or scarring) are used for the symmastia repair.

This patient is only 2 months out from surgery and is pleased with her new and improved look.

Testimonial:

I had my first breast augmentation surgery a little over 2 years ago from another doctor. I knew something was wrong as soon as the bandages were removed. I will never forget that day, I cried the second I saw my new breasts- that didn’t look like breasts at all. My doctor (at the time) told me that it was because my scar tissue had become too tight and it was pushing my breasts towards each other. He suggested a second surgery in which he would fix the problem. Needless to say the second surgery did absolutely nothing to fix the problem; it was nothing but an unnecessary surgery. I knew that something was out of wack, and began to do my own research. I found out about symmastia and knew that it was what I had. I gave my doctor the benefit of the doubt and went back to him one more time. He basically told me that this is just how my body is, and I was going to have to deal. He told me he would perform the same surgery again (if it didn’t help the first time why would it help the second time!!!)

That’s when I began my search for a doctor to fix me! I got extremely lucky and came across Dr. Pousti’s web page while doing further research about symmastia. He is the only doctor in the area I found that specializes in the procedure (and I only saw a few others in the whole country). I made an appointment right away.

I came in for my consult and was blown away by the difference in treatment I received from the very start. The waiting room has a spa feel to it. The girls that work in the office are all amazing and take wonderful care of us patients. Dr. Pousti sat and talked with me longer than my other doctor saw me the whole time I was his patient. He made me feel comfortable, and although it was hard to trust another doctor, Dr. Pousti gained my trust right away. I was told from the beginning that if he felt he couldn’t fix me that he would tell me. Luckily he said I had a great chance of being fixed. Although it wasn’t 100% there is no one else I would have trusted to do a better job.

The day of my surgery is still a blur. One thing I do remember is the beautiful flowers I received from Dr. Pousti and his staff. They brightened my day. I don’t remember much of the first week because of the painkillers, but I’m not going to lie- the road to recovery for this procedure is harder than a breast augmentation alone. You’re not supposed to do much of anything for awhile after. Although I wasn’t in a ton of pain, I began to get antsy because it’s hard not being able to lift your arms or pick things up. Although not having to vacuum for an extended period of time has been great, my boyfriend misses having me there to help him clean.

The difference this surgery has made on my body is amazing. After my first breast augmentation I gained some weight because I was so depressed. I looked even worse because of the way my breasts were placed- almost like a tree trunk. Now, although I still have a little bit of extra weight on me I look curvy- and feel amazing. Thank you so much Dr. Pousti for making me feel like the woman I wanted to feel like over two years ago when I first decided to have this done. The results are amazing, and I would recommend you to all of my friends, family, anyone. And thanks to the girls in the office for making this whole process much more enjoyable than surgery normally would be. I plan on coming back to Dr. Pousti if I ever need anything else done.

This patient had her first breast augmentation surgery 1-2 years ago in Florida. After some time, she noticed the mal-position of her breast implants. She became very concerned about her developing symmastia. Symmastia - commonly referred to as “breadloafing” 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, and is a problem for implants over or under the muscle, though submuscular implant placement allows the muscle to provide some softening of the transition to the cleavage area from the augmented breast mound.

Dr. Pousti has many patient’s who he has helped with reconstruction after symmastia developement. Markings were done with very accurate measurements to achieve the goals of the patient. This patient wanted small implants because of her petite frame.

Pictures were taken with different bras and the markings showing to assist Dr. Pousti with his surgical plan for this patient.

In the operating room, Dr. Pousti and his staff take great care to create a natural look for this patient.

In the O.R., one side is corrected.

In the O.R., both sides corrected.

Tape is placed for support.

When the patient wakes up from surgery, she will have a supportive bra as well as the tape that is placed in the operating room to protect her breasts.

The patient is just weeks out from symmastia repair and extremely happy with her results.

Testimonial:

I had suffered from symmastia after I had my first breast augmentation done by a plastic surgeon in Florida. I was happy to learn that Dr. Pousti had experience with symmastia correction and was 100% certain that he was the one I wanted to fix my problem. Dr. Pousti has been great from the moment my husband and I met him. He has been very kind and he informed us in great detail about he procedure. Now, 5 weeks after my operation, I would not be any happier with the results. Not only is the symmastia corrected, but Dr. Pousti was also able to consider my wishes regarding the size and look of my breasts. Dr. Pousti is a great surgeon and I am convinced that everyone who suffers from symmastia cannot find a more qualified and experienced surgeon int he U.S. to correct this problem. I am very thankful to Dr. Pousti and his outstanding staff!!

This patient had her first breast augmentation surgery October of 2005. She noticed “bottoming out” of both of her breast implants. The shape and position were not what she was looking for and she was very upset about the outcome. She did some research on the internet to find a board certified plastic surgeon in Southern California to help her correct her problem and she found Dr. Pousti.

She met with Dr. Pousti multiple times and decided to proceed with revisionary breast surgery to correct the “bottoming out” of her current implants and to correct the “puffiness” of her areola.

Markings were performed the night before surgery. Dr. Pousti explained the procedure and how her results would be achieved.

In the operating room, Dr. Pousti takes time to achieve the patient’s goals.

Before the surgery begins.

After Dr. Pousti has finished.

The patient is just 2 months out from her revisionary breast augmentation surgery and extremely happy with her results.