Revisionary Surgery: Correction of symmastia and bottoming out of implants with silicone gel implants
|
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.
|
IN THE OPERATING ROOM:
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.
 |
 |
Testimonial:
want to say thank you from the bottom of my heart for the amazing work you did for my breasts. The results are dramatically better than before.
When I first met you and your staff, I knew it had to be you to perform my surgery. I could tell that with your honesty with me in going over how extensive it was going to be and that it would be a challenge, your being double board certified, your knowledge and experience of the techniques that were needed for my surgery, and listening to and understanding of my concerns, as well as time you spent with me answering my questions and explaining the procedure you would do, you had to be the one to perform this. To fix me, really. Also to know of and see the pictures of girls that you performed this type of surgery on before, and their incredible results, just sealed the deal for me.
When my sister told me that her and two of our friends were considering getting a breast augmentation. I told them they just had to meet you. I actually said “ If he can fix my boobs with how bad they are right now, imagine how amazing yours will look with it being your first surgery!” After meeting you and your staff, and learning of your certifications, they felt the same way too. So all four of us ended up going to the pre-op consultations together!
Having our surgeries split between two days was so nice; to experience it all together and see the results together.
I was so scared to go through surgery again, since my first one with that doctor in Mexico was really bad. Terrified actually. But you reassured me that you’ve done this before, and explained all of the things you were going to do, how my healing time (post-op) would be, etc. Your confidence in the surgery and results of it, and patience and consideration of my feelings really reassured me that I was going to be okay. My husband helped also by reminding me of what you’ve said any time my worries came back again. The surgery center was so wonderful. Michelle, my nurse, was so sweet. I felt like I was on my way to get a facial and massage the way she was so caring and trying to help me relax, not surgery! I have never been to a physician’s office or surgery center before, and felt so… taken care of. Like I was the top priority, as if you had only my surgery to perform—when in reality I know that you have many patients and surgeries. I just loved, and still do!, the quality of time and attention you’ve given to me and my friends.
All your “ Gray hairs and sleepless nights” I caused you paid off, Dr. Pousti. My ‘girls’ are amazing now. The results are so beautiful; my husband definitely thinks so too. With the way they looked before, when you had me bring in photos of breasts I liked ( size, shape, cleavage), I didn’t think my results would be even near those photos. I figured they were just an idea; a goal of what I liked. So I thought ‘atleast my breasts won’t have the symmastia, bottoming out, and capsulation anymore’. But no, they do look like the photos I brought in! I can’t believe the difference. They even feel better too! They’re definitely above and beyond what my expectations were, and I am so very thankful for that.
If they were to ever have an award ceremony for Surgeon’s (which they should!), you would definitely be awarded with ‘Best Breast Revision Surgery’ for ‘ Attention to Detail, Using the Most Current Techniques, and Quality of the Patients Entire Experience.’ Thank you Dr. Pousti. Myself, my sister Iris, and our friends Stephanie, and Lacey all appreciate our results so much, and the entire experience leading up to it.
Your Forever Appreciative Patient