Revision Breast Augmentation- Removal of Capsular Contracture

Thursday, September 23rd, 2010

This 77-year-old patient from El Cajon, California developed encapsulation (scar tissue) after breast surgery performed by a previous doctor 21 years ago. Scar tissue can cause major discomfort and pain. The patient decided to take care of her scar tissue and proceed with revisionary breast surgery. While shopping for a plastic surgeon she found Dr. Pousti online and was impressed with his experience in reconstructive surgery.

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During examination Dr. Pousti explained to the patient that a mastopexy, also known as a breast lift, would be needed to give her the best results. The surgeon and the patient meet the day before surgery to do measurements and markings and the procedure is explained to them. The ‘X’ marks you see below indicate where the areola will be located once the lift is performed and the arrows show where the patient would like fullness to be increased.

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Once the scar tissue, along with the implants, are removed the lift is performed and implants are set into place. The incisions are closed with dissolvable sutures and she is placed in the upright position to ensure symmetry and make sure that size goals are achieved.

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The patient is post op removal of her old implants as well as scar tissue and replacement of new breast implants with a mastopexy and capsulectomy. She is very happy with the results that Dr. Pousti was able to provide her with.

Implant Exchange with AlloGraft

Friday, August 20th, 2010

This 21-year old patient was unhappy with her previous breast surgery (performed by another surgeon). She wanted revisionary breast surgery to correct the mal-position of her right breast and to remove her saline breast implants and replace them with larger breast implants.

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The patient is from Philadelphia and flew into San Diego, California to have breast revision surgery performed by Dr. Pousti.

DSC04399 before markings front

DSC04395 before surgery laying down

You can see the mal-position of the right breast; the breasts were asymmetric and she was unhappy with the appearance. She wanted more cleavage, fullness and breast projection.

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In order to repair and correct the mal-position of her left breast, internal sutures were used and placed to position the breast more medially (middle), then AlloGraft (a surgical graft tissue) to strengthen the repaired areas.

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Here you can see the placement of the AlloGraft tissue.

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The patient without implants, Allograft and internal sutures in place.

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New saline breast implants were placed submuscularly and filled too 960cc in both breasts.

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Before side profile

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She is extremely happy with her results and sends updates and pictures via e-mail daily.

Revision of Implants Surgery

Friday, August 20th, 2010

This 46-year old patient from Escondido, California is post breast augmentation surgery in 2000, performed by another surgeon. She wanted revisionary breast surgery to go larger in breast size.

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After 10-years post-op breast surgery, the patient decided to significantly increase her breast size and also replace her current implants with silicone gel breast implants.

O.R. 11.25 before surgery side

O.R. 11.25 front before surgeyr

While performing markings, Dr. Pousti sits the patient in the upright and laying down position to ensure symmetry in both positions for the patients and achieve the best look for the patient.

O.R. 11.25 no implants

With the previous implants removed, Dr. Pousti creates new breast pockets and space for cleavage and fullness  for the new larger silicone gel implants.

O.R. 11.25 done front

Moderate plus profile 800cc silicone gel implants were placed submuscularly in both breasts, made by Mentor Corporation.

Implant Exchange Surgery

Friday, August 20th, 2010

This 34-year old patient from Chula Vista, California (South San Diego County) had breast augmentation surgery with a limited breast lift (mastopexy) on the left breast in 2009.

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The patient before breast augmentation surgery.

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The patient 6-months post-op surgery.

The patient was extremely happy with her surgery and knew that Dr. Pousti would achieve exactly what she wanted. After a couple years, the patient wanted to “Go Bigger”.

When patient decided that she wanted to have revisionary breast surgery with extra large implants, she knew she wanted Dr. Pousti to perform her surgery.

O.R. 4.5 before surgery markings

The patient previously had saline breast implants filled to 400cc in the right breast and 380cc in the left breast.

O.R. 4.5 after surgery front

O.R. 4.5 after surgery side

In order to achieve her desired look, Dr. Pousti removed her previous saline implants and were replaced with new saline implants then filled to 600cc in both breasts. The patient is very happy with her new body proportions and is now 3-weeks post-op surgery. The patient will continue to settle over time.

Breast Revision Surgery – Encapsulation

Friday, August 20th, 2010

This 62-year old patient from Escondido, California (North San Diego County) had (subglandular) breast augmentation surgery with silicone implants in the 1980’s performed by another surgeon.The patient had significant encapsulation in both breasts and experienced breast pain in her right breast.

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The patient was interested in revisionary breast surgery for many years and decided to proceed with surgery after meeting Dr. Pousti.

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Due to encapsulation, the patient was unhappy with the results of her surgery.  The patient described to Dr. Pousti that she just wanted to look natural and have some fullness and cleavage. Markings were performed the morning of surgery, and the planned procedure was drawn out in detail.

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Breast capsule removed from patient.

Dr. Pousti removed the patient’s 30-year-old silicone breast implants and performed capsulectomy in both breasts.

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421cc silicone-GEL breast implants were used to replaced the previous implants with submuscular placement (implants placed under the muscle).

Implant Deflation – Breast Revision Surgery

Friday, July 30th, 2010

This 30-year old patient from Hemet, California (Riverside, California) unfortunately had implant deflation in 2007, after breast augmentation surgery in 1999 (performed by another surgeon). She went back to her previous surgeon for implant exchange surgery and felt her previous surgeon did not want to help her. She was very frustrated and decided to research for another plastic surgeon to perform her surgery. Her friends who are patients of Dr. Pousti referred her. Because many of her friends went to Dr. Pousti for surgery and has great results, the patient knew that Dr. Pousti would take care of her.

She met with Dr. Pousti in Murrieta to discuss revisionary breast surgery and breast lift surgery (mastopexy) .

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She felt very comfortable with Dr. Pousti’s experience and decided to proceed with surgery.

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Markings were performed prior to surgery, again Dr. Pousti also discussed the details of breast lift surgery (mastopexy) to the patient.

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Dr. Pousti clearly marks desired fullness, and also, you can see the “new” position of the nipple and areola complexes.

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The defective implants were removed and replaced with new saline breast implants. Dr. Pousti demonstrates the difference before the completed right breast and the incomplete left breast.

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Deflated implants removed.

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Immediately after surgery. Fullness and cleavage achieved with breast lift (mastopexy) and saline breast implants filled to 575cc in both breasts with submuscular placement.

The patient is now 13-months post-op surgery and is very happy with the results.

Breast Revision with XL Silicone Gel Implants

Friday, July 30th, 2010

This 46-year old patient from Escondido, California had breast augmentation surgery in 2000, performed by another surgeon. After 10 years, the patient decided to have revisionary breast surgery with larger silicone gel breast implants.

11.6 front

11.6 left

After 10-years post-op breast surgery, the patient decided to significantly increase her breast size and also replace her current implants with silicone gel breast implants.

O.R. 11.25 before surgery side

O.R. 11.25 front before surgeyr

While performing markings, Dr. Pousti sits the patient in the upright and laying down position to ensure symmetry in both positions for the patients and achieve the best look for the patient.

O.R. 11.25 no implants

With the previous implants removed, Dr. Pousti creates new breast pockets and space for cleavage and fullness  for the new larger silicone gel implants.

O.R. 11.25 done front

Moderate plus profile 800cc silicone gel implants were placed submuscularly in both breasts, made by Mentor Corporation.

Correction of Bottoming Out

Wednesday, July 28th, 2010

This 29-year old patient from Arizona is post op breast augmentation surgery (performed by another plastic surgeon). She was unhappy with the “bottoming out” and lateral displacement of her breast implants and was interested in breast implant revision.

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The patient decided wanted to have correction of bottoming out performed, along with replacing her current saline breast implants for larger silicone-gel breast implants.

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By performing markings, Dr. Pousti is able to map out her surgery, while discussing her surgery in detail.

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OR Camera 002 before surgery markings

The patient explained, while laying down she was unhappy with the position of her implants and she wanted more projection and cleavage.

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Before surgery with markings

OR Camera 005 one sideCompleted right breast correct, Internal sutures were used to correct the “bottoming out” and lateral displacement. Temporary in-sizer were used to determine the goal look and size of the patients desired look.

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752cc silicone gel implants were placed submuscularly in both breasts made by Allergan Corporation. The patient is very happy with the improved appearance of her breasts.

AlloGraft – Breast Revisionary Surgery

Wednesday, July 28th, 2010

This 21-year old patient flew into San Diego, California to have revisionary breast surgery to correct the mal-position of her right breast and to remove her saline breast implants and replace them with larger breast implants. She had heard of Reconstructive Surgeon, Dr. Pousti and knew he would be the best surgeon to perform her surgery.

DSC06907 front

DSC06909 left

The patient is from Philadelphia and flew into San Diego, California to have breast revision surgery performed by Dr. Pousti.

DSC04399 before markings front

DSC04395 before surgery laying down

You can see the mal-position of the right breast; the breasts were asymmetric and she was unhappy with the appearance. She wanted more cleavage, fullness and breast projection.

DSC04401 allograft tissue

In order to repair and correct the mal-position of her left breast, internal sutures were used and placed to position the breast more medially (middle), then AlloGraft (a surgical graft tissue) to strengthen the repaired areas.

DSC04403 allograft

Here you can see the placement of the AlloGraft tissue.

DSC04402 no implamys

The patient without implants, Allograft and internal sutures in place.

DSC04412 done front

New saline breast implants were placed submuscularly and filled too 960cc in both breasts.

DSC04398 before surgery markings side

Before side profile

DSC04411 done side

She is extremely happy with her results and sends updates and pictures via e-mail daily.

REVISIONARY SURGERY:Bilateral Removal of Saline implants Bilateral Replacement with Silicone Gel Implants Right breast Reconstruction with Alloderm

Monday, January 4th, 2010

This 23-year old patient from San Diego County researched for a surgeon who would be able to help her with her revisionary surgery. She had a breast augmentation 2 years ago and had 540cc saline implants placed under the pectoralis muscle with a different surgeon. Very soon after her first surgery, she underwent a second operation on the right side for to remove scar tissue from around the implant (capsulectomy).

After these 2 surgeries, she was left with breast asymmetry, severe rippling and palpability of the right breast implant as well as the implant being very close to the skin on the right side. Her implants had also “bottomed out”.


As seen here, the implant is dangerously close to the surface on the right side.

She wished to go larger with silicone gel implants that have recently been FDA approved for breast augmentation surgery to reduce the rippling and palpability that she was experiencing. She also wanted to address the problem of the right implant being too close to the surface. She understood that her implants had “bottomed out” (her nipple-areola complexes were pointing up) but she did not want to address this issue at this time.

The breasts are marked prior to correcting. Both breast implants have been removed

Dr. Pousti removed her current saline implants and replaced them with 600cc silicone gel implants. He also performed right breast reconstruction using a 6 by 16cm piece of Alloderm Regenerative Tissue Matrix to protect the right implant and prevent it from coming too close to the surface.

Although she did not want her “bottoming out” addressed, she notices that Dr. Pousti significantly improved it. She no longer has a palpable implant on the right side and it is no longer dangerously close to the skin.

She is only 2 weeks post-op but very pleased with the results of her surgery. The scars will fade with time.

Testimonial:

Hi to Dr. Pousti and Staff :) I could go on and on, but I tried to make this testimonial as concise as possible for future patients. First let me thank all of you from the bottom of my heart!! Thank you for caring the way that you have :)

I’m writing this for anyone considering breast augmentation surgery, or anyone who is coming to Dr. Pousti for revision surgery. I moved to San Diego in August of ‘06 and new that finding a doctor to do my revision surgery was a main priority for me. I had lived with a previous complication for two years with increasing difficulty as it kept getting worse and worse. The hardest part of the process for me was learning to trust a surgeon again after my past experience. I’m 23 and had already had two surgeries, and the amount of emotional stress I had for the past two+ years had worn me down. I found Dr. Pousti online and came in for a consultation within a couple weeks of moving here. After meeting with him, looking at pictures online, and reading patients testimonials, I knew he was the man for me!! (Not to mention his wonderful staff)
I had a pretty serious/complicated issue (take a look at the before and after pics!) I was pretty much hopeless that I would ever be anything but deformed… and yet Dr. Pousti. didn’t turn me away, instead he worked with me and did research on new techniques in breast revision surgery using AlloDerm Regenerative Tissue. He went out of his way to help me, and treated me like and individual person instead of a paying customer. I will be forever grateful for the extra effort he put into my case :) It’s now Feb ‘07 and I am more than a month out of surgery, the revision surgery went better than I could ever have imagined. He did an amazing job!!
One thing I would like to add because I think it is a common misconception with female patients, is about male surgeons. I know that after having a male doctor for my first two surgeries I was frustrated because I felt like men didn’t take the time to listen to me, and (with my young appearance) treated me like a child. So before meeting Pousti I had consulted with a female surgeon in the area thinking maybe that was the answer… I was wrong, she was actually worse than my previous surgeon, and made assumptions about what I wanted and didn’t want without asking me. In short, It’s not about a male doctor or a female doctor, it’s about the person.
I would strongly recommend him to anyone considering cosmetic surgery, honestly he is a very talented surgeon. If you are consulting with him because you are facing a revisionary surgery, he is someone you can trust, he’s completely honest, and he really does care about his patients. Best of luck with your future surgery :)