Breast Revision San Diego

La Jolla / San Diego Cosmetic Surgeon Dr. Tom Pousti Talks About Revisionary Breast Surgery

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Frequently Asked Questions


Some patients need to have revisionary breast surgery because of deflation of a breast implant, capsular contracture formed around one or both implants, double bubble formation, etc..

One of the more common problems that patients are seeking Dr. Pousti’s help for is 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.

Another common problem that we see in our office is the need for AlloDerm Regenerative Tissue use to help cover the implant when the pectoralis muscle has been damaged and is not giving enough coverage to the area.

The Surgical Procedure

The operation time varies depending on what exactly would need to be performed. We will review this with you after you have been examined by Dr. Pousti.

For correction of symmastia, the procedure can take from 2-3 hours depending on how much work is involved. Board Certified Plastic Surgeon, Dr. Pousti takes his time in the operating room to make sure that he does what he can to achieve the patient’s results. The repair of symmastia requires additional surgery to move the implant back into the pocket of original placement.

• The tissue that encapsulates the implant is cut and rolled back to fit into the pocket.
• Tissue is sutured together to hold implant in place.
• The muscle is then sutured internally back in place, connecting the sternum.
• The incision is then sutured close.

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What To Expect After Surgery

Pain is rarely strong, more commonly being a degree of discomfort. Swelling occurs but usually begins to subside by the third or fourth day. Some degree of swelling may persist for longer periods. A well-fitted bra is worn day and night for three weeks. While there is probably seldom interference with future breast feeding, women are cautioned that it may not be possible to breast feed in the future.

The bra that is worn after symmastia repair is referred to as the “thong bra”. It is used to stabilize the area after symmastia reconstruction.

Resumption Of Physical Activities

Driving may be resumed in 1-2 weeks.
Non-contact sports in 3 weeks.
Contact sports in 6 weeks.


I had nearly a dozen consults over the years before I finally decided to have breast augmentation surgery in 2007 at age 34. I chose to have my surgery in Alaska where I live (basically for convenience). I was extremely unhappy with my results and my surgeon’s lack of desire to address my concerns. I finally obtained a second opinion and was told surprising facts about my surgery that explained many of my issues. I also received confirmation that the recommendations provided by my plastic surgeon were not going to solve the underlying problems. I was heart broken. I had many concerns going into this elective surgery. I had put much trust in my surgeon and felt betrayed by her. I wanted to have revision surgery, but was scared to trust another surgeon. I had been blogging on several of the popular plastic surgery websites and Dr. Tom Pousti’s name kept popping up. Patient after patient told their stories of surgery nightmares and how Dr. Pousti was able to correct their problems and restore their broken spirits. I could not ignore their testimonials, so I researched him myself and decided to go about planning the revsionary surgery. First, I

e-mailed his office and was shocked to receive a call from Dr. Pousti himself the very next morning! I e-mailed pictures and we discussed the revisionary surgery a few more times over the phone. His office staff was extremely helpful and quickly responded to any questions I had regarding the surgery and planning my trip. I met with Dr. Pousti the afternoon before surgery and had a completely successful surgery in the morning. I cannot thank Dr. Pousti and his caring staff enough for all that they have done for me! My breasts are healing beautifully and the results already far exceed my expectations. Dr. Pousti has true compassion for his patients. This is evident in the manner in which he treats them and the skillful work he performs on them. He is an impressive surgeon and artist and a truly kind person. I would recommend him to ANYONE considering plastic surgery. He is definitely worth any amount of travel. His office now considers me part of their “family” and I am proud to be associated with such an impressive team!



Monday, January 5, 2009

Dear Dr. Mohedin,

I’d like to thank you for recommending Dr Tom Pousti. I called his office and was given an immediate appointment. After a short visit and examination he correctly diagnosed the source of my pain and discomfort to a leak in my implant on my right side. I felt a certain urgency to alleviate my pain as soon as possible. Dr. Pousti and staff were so great to help me get into the surgery center that very next Thursday-just six days after my initial consultation. This scheduling was a little quicker than the usual and throughout the entire preparation phase, Dr Pousti’s office staff was amazingly efficient and always a step ahead of the process.

On the day of the surgery I arrived at the Alvarado Surgery Center. The staff there was also wonderfully efficient and professional. I received first-rate care during my arrival, preparation, surgery and post-op.

Dr. Pousti’s kind care and concern made for a wonderfully comfortable bedside manner. His knowledge and application of his craft are second to none. In addition to that, he has a relaxed and personable approach while simultaneously taking complete charge of the situation. That instills great confidence in what can be a unsettling procedure.

The result was simply phenomenal! We decided to remove the old implants and replace them with new ones with some minor “adjustments” in the process. Dr Pousti’s blend of medical knowledge along with his incredible attention to cosmetic and artistic detail gave me a great sense of ease as we progressed through the decisions and the surgery itself.

It has been just a little over three weeks since my surgery and I couldn’t be more pleased with the experience and the result. Please allow me to thank you once again for this recommendation and your kind care for me over the years.


Mary Jane Torpin

Implant Exchange, Silicone Gel Implants, Breast Lift:

I first found Dr. Pousti in 2001 in my search for a Board Certified Plastic Surgeon. Not only was he Board certified but double board certified. I was interested in a Breast Augmentation and was VERY impressed with his mastering art of Cosmetic Surgery. Every picture that I saw on his website was just beautiful.

Once arriving to my initial consultation and meeting Dr. Pousti I knew that he was the surgeon that was to perform my surgery. His staff is first class and helped me with anything and everything I needed. During the consultation he explained the surgery itself in detail and spent a good amount of time with me and answered all of my questions. I never felt like I was rushed or just a number. He really took his time with me and made me feel really comfortable. He is very caring, respectful, compassionate about his work, genuine, has wonderful bedside manners and is just an all around great man. We looked through pictures that I wanted to use as a guide and met with his actual post-op patients that were in the office. I really thought that the patients that shared their wonderful experience with me was very helpful. Before I left his office I knew that I had to schedule my surgery.

My surgery went extremely well. Dr. Pousti was with me the whole time through the morning of my surgery. I really felt like he cared and he even took the time the night of my surgery to contact me to make sure that I was doing ok. I was very happy with my results/experience and decided to go larger in 2002 with Saline implants. The 2nd time around was even easier then the 1st. My incisions were near to nothing. I couldn’t ask for a better surgeon to perform surgery on me and that’s why he performed my 3rd!! I am now 3 weeks post-op from a Breast Augmentation with a lift and switched to Silicone implants. After having the larger implants I decided that I wanted a little more conservative size and downsized and switched to silicone. The 3rd time around I can and will say that I still have the up most respect for Dr. Pousti and the gift that he was given. He does amazing work and will continue to do so. I am VERY happy with my results and can’t wait to see the end result.

Dr. Pousti does amazing work as it speaks for itself. I have and will continue to refer my friends and family to him.

Thanks Dr. Pousti!!!!

Revisionary Breast Surgery with Alloderm:

Dr. Pousti and Staff,

After suffering a serious injury to my pectoral muscle, I found myself in need of surgery and recognized, after evaluation by several other plastic surgeons, that my case would be difficult with an unpredictable outcome. I began to search for the doctor that would be the best to do the repair- I finally located you after extensive research. Your familiarity of the use of Alloderm as your replacement tissue and your amazing artistic ability has truly been my saving grace. My “revisionary” surgery has proven far superior and much more beautiful than my original breast augmentation. I wish I had found you years ago for the original implants, but I feel blessed to have found you now. My trip from Arkansas was so worth while! Wonderful staff- Awesome you!

Sandra O.


From the patient’s significant other:

I would like to express my sincere thank you for such a great job. The original augmentation was less than satisfactory and the injury sustained was drastic, as you well know and the results of your work outshine that tremendously. Sandra is very happy and as a result has a much better outlook regarding her appearance.. She was always great to me regardless and still is. I thank you once again for your skill and judgment in regards to sizing, shape, etc. I feel that you have captured the perfect essence of her femininity with your work, I am sure in the month to come as she heals that your work will only become better as well.. once again thank you for your time, patience, skill, and personal attention to her when she first contacted your office and staff. At the very beginning she was so distraught and after talking to everyone there became much more relaxed and assured that she was in good hands.

Revisionary Breast Surgery:

Dear Dr. Pousti and Staff-

I just wanted to take a moment to thank you all for the compassion and quality service that I received while under your care. I could not have achieved the amazing look and feel of my ‘new breasts’ with any other office. I am extremely pleased with the results. Thanks a ton!

To Anyone Considering Revisionary Breast Surgery:

I had breast augmentation preformed about two years ago by a surgeon in North Carolina. Within a year of the surgery I began to have complications. I noticed a small bump forming beneath the skin on my right breast. Within a year the bump had grown and caused the breast to become misshapen and uncomfortable. It was even noticeable when I had a lined bra and clothing on. I later came to find out that the ‘bump’ was actually the implant pushing its way through my skin. I knew that I needed to have the problem corrected right away!

I was apprehensive about finding a surgeon that specialized in revisionary breast surgery. However, I had received many recommendations for Dr. Pousti and decided to schedule an appointment. From the moment that I met with Dr. Pousti I felt at ease with my decision to have my surgery performed by him. Dr. Pousti reassured me that he would to the best possible job to fix my problem. Within the month I scheduled the surgery.

After everything was over and done with I couldn’t have been more happy! My breasts looked awesome! The bump was gone and I could not believe how natural they looked and felt. I could hardly wait to show off my new ‘look’ to my husband.

Dr. Pousti and his staff did an excellent job and I would recommend them in a heartbeat. I appreciated their compassion and outstanding service. Dr. Pousti is knowledgeable and very skilled in his profession yet he is humble and truly cares about each individual that he works with. I am VERY pleased with my results!

Revisionary Breast Surgery:

“What can I say?” I’m extremely thrilled to be writing and sharing my happiness, and gratitude with my Breast Revision results. My first Breast Augmentation was six years ago, right before my wedding. Every woman wants to feel perfect on her big day. I was an “A” cup for the longest time and I remember since I was 14 years old wanting bigger breasts. I just knew I’d feel more like a woman, sexier too. My soon to be husband was extremely scared for me to have the surgery. Six months after our wedding, I got pregnant… Not enough time for me to enjoy my new, round and perky breasts. Did I mention that my husband loved my new boobies? I am 29 years old now. I have two beautiful children, both of whom I’ve breastfed successfully with the implants. But what happened to the shape of my breasts after the breastfeeding left me feeling depressed, and I also developed horrible scar tissue, the medical term is called Capsular Contracture. My scar tissue got so bad I had trouble sleeping at night. I am a very active woman. I’ve even competed in the Boston Marathon. After finishing breastfeeding my son, I immediately went back to my doctor in hopes of him fixing my breasts. Come to find out he retired and a very prominent doctor took over his practice. I met with this doctor but I did not feel like he cared about me at all. He had a very fancy office, with all of his own paintings that he painted, hanging in every room. The staff was also very quiet, no smiles and they seemed unapproachable. I went to three appointments with this doctor discussing my wants hoping to like him and feel comfortable with his approach in fixing my breasts. This doctor wanted to give me a full lift, and what that means is a lot of scars basically. I left his office with a fancy price, and I was completely frustrated and confused as to whether or not I wanted this guy to do my operation. I decided that I was going to visit other doctors. During my hunt for the right doctor, my sister mentioned Dr. Pousti’s name. That a lot of the women at her gym have seen him for various operations and were very pleased with their results. I was very afraid when I went into Dr. Pousti’s office. When Dr. Pousti came in the room to meet with me I just let it all out. I expressed to him my frustrations, and I asked him how do you know if you found the right doctor? I said I’m scared, I don’t know what to look for, I want this operation done right, but how do i know if you’re the right one? Dr. Pousti took me around his office and showed me his credentials and explained to me what they meant, and he also took it a step further and had me meet with patients in his office that day only a week or two out of surgery, and I couldn’t believe my eyes how stunning everyone’s breasts looked. They were women of all ages. Dr. Pousti just kept bringing them in one by one. And the women shared with me their experiences with Dr. Pousti and how happy they were with their results. I needed a doctor to care about me, and to want to give me the best results. When he looked at me I could tell he was an artist, he cared deeply about his work and he told me, “I can fix your breasts without a lift.” “You are young and beautiful, and don’t need those scars.” I couldn’t agree more. I went home that night and told my husband that I had found the right doctor. I said that he took over an hour with me, talking with me, wanting me to feel comfortable with him, and that he even showed me several of his patients just out of surgery, and that I couldn’t believe how beautiful everyone looked. I said this is the guy I want to do my surgery. Dr. Pousti had his work cut out for him. He had to do a Capsulectomy (removal of the scar tissue) and Breast asymmetry and re-augmentation. The growing scar tissue had severely changed the shape of my breasts, so he had to reshape them as well. I couldn’t be happier today. I know I made the right decision in choosing Dr. Pousti. I have not only come to really liking Dr. Pousti, but his staff of women, his team, is amazing as well. I love all of them. We talk about our kids, we laugh and share stories together, when I walk in that office, I am always greeted with a smile. I feel like a million bucks. Dr. Pousti and his wonderful team have helped improve the quality of my life. Thank you Dr. Pousti for taking the time to help me feel comfortable, and confident in your abilities, and for helping me now love again, my new boobies.


San Diego, CA

Revisionary Breast Surgery with Alloderm:

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. 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 :)

Revisionary Breast Surgery with Silicone Gel Implants

Dr. Pousti and Staff,

I can’t thank you enough for the wonderful experience of being your patient and my results are beyond my expectations.

I was so broken hearted when my first augmentation left me with a terrible case of capsular contracture in both breasts. My husband’s job was transferring us to California, and I had pretty much lost faith in my previous surgeon who’s PA was the only person I saw at any appointment after my augmentation, disregarded my concerns from early on. I started researching surgeons in California and came upon your site. I honestly thought you had to be too good to be true, mind you, I was skeptical of any surgeon by this point.

When we were finally settled in from our cross country move, I made an appointment to see you, again very skeptical of how it would go. I had so many mixed emotions about even having a second augmentation, but the contracture left me with constant discomfort.

When my husband and I entered your office, your staff was so warm and friendly. They immediately ushered me off to meet with a patient who was only a few weeks into her recovery, and then another. I was very impressed with that. There is nothing better than hearing experiences from an actual patient.

When the time came to sit and speak with you about my case, you took time to answer all of my questions, and because of my previous experience I left no stone unturned. You didn’t always tell me what I wanted to hear, you were very honest with me about what to expect. I asked you “What happens if I develop a contracture relatively soon again?” Your answer to me was, “If there is no pain involved, I suggest we do nothing, and if there is pain involved, I would suggest we consider removing the implants all together.” This was the point that my husband and I KNEW you were the surgeon for me. I felt as though you were putting the best interest of your patient before anything lucrative for yourself. YOU CARED! I wasn’t just another patient file.

I am six months post op, and I have remarkable results. I have gone from having a notable difference in symmetry, square, hard breasts to something that looks very natural on my frame. The few people I have shared my augmentation experience with have said they would have never known I’d had surgery by looking at me. You quelled all of my concerns, all my fears, and all my self-consciousness. I have several friends are interested in having cosmetic procedures, and I’ve referred them all to you.

Again, I can not thank you or your staff enough. From the time I first walked into your office, through my surgery (you have an impeccable bedside manner), and through out all of my post op visits, each of you has greeted me by name, even without my chart in hand, and have always been “First Class.”


San Diego, CA

Revisionary Breast Surgery with Saline Implants:

Please let everyone know that I am VERY HAPPY with my results thus far.  Of course, the swelling could go down, but I have to take that up with my own body.  I am astonished at how well my breasts look.  The incision that Dr. Pousti made is healing up very nicely – hardly noticeable.  And the sizing is PERFECT.  Not too big, not too small – just right for my body frame.  How does he do it?    My tummy is healing very nicely as well, and is 1000 times better then where I started from.   In all honesty, I am amazed at what I see.  I could almost get away with a bikini.  I could never say that before.

Thanks so much to all of you, especially you, Anna, Daisy, (I think it was Kelso at the recovery center – she is totally awesome) and of course, Dr. Pousti.

A big hug from Montana.