What size? Revision BA - La Mesa, CA

I have been thinking about a revision for at least...

I have been thinking about a revision for at least 10 years. While I love by BA, I wanted better cleavage. When I chanced upon Dr. Pousti's website, I realized that his advanced techniques could make this wish a reality. I had researched other doctors for quite awhile, and never felt that I would get an improvement, over what I had with them, so I waited. And talk about meant to be, we live 5 minutes away from his office! He and his staff were warm and welcoming, and I felt all my concerns were addressed. I was very nervous, but after my pre-op visit, yesterday, I feel much more at peace and relieved. While I am excited about my new physique, I am definitely less-than-thrilled about 2 months of no yoga! That amount of time missing classes does not make me happy, but the trade-off WILL be worth it.

My twenty year-old implants are silicone. Dr....

My twenty year-old implants are silicone. Dr. Pousti seems to think that the right one had started leaking about five years, and caused capsular contracture. So between the widely spaced implants, and the right one which had hardened, I felt it would be a good time to get replacements. Especially since Dr. Pousti has special techniques to address my unique anatomical issues to give me the results I dream about. Prior to implants, I was a card carrying member of the "Itty bitty Titty Committee" and wore a t-shirt which proclaimed it, as if anyone didn't find it obvious already! Mosquito bites for tits!

So here is my dilemma. I always wanted boobs that were big enough to look like I was "normal". As circumstances would have it, I met a man who was a "boob man." I find this ridiculous as my backside and legs are my superior external qualities. I have a dancer's build. Anyway, fast forward through my BA where i got large implants to give me a C/D size, mainly I think I was curious to live like a "lucky" woman, and also because of my husband's wishes.

Now I have the opportunity to change the implants to get exactly what i want. The problem is I am conflicted. I weigh 128 lb, and am 5'6". I am small-to-medium boned, with a pigeon rib cage that aims the implants our to the side. Dr. Pousti assures me he can build internal structure in, so the implants point forward, and even can add cleavage!? I am lean, muscular and I have a short torso. I am telling you all this and adding some photos so you can help me decide which way to go. Smaller and proportioned, or more exuberant? What do you think?

I have decided I would like to turn out like the...

I have decided I would like to turn out like the goal picture. The person is shaped like me and is muscular like me, so I think I could get that result. I would be super happy if I had cleavage. Dr. Pousti is super nice and gives me as many appointments as necessary to ask all my questions. He seems so confident that he can deliver great results that it is infectious. I am nervous about going under though. I know I have done it before, but I think the waking up part and assessing the damage is what bugs me. I also am not looking forward to no yoga for awhile, but it is a necessary trade off.

It is the morning of surgery. I would be far more...

It is the morning of surgery. I would be far more nervous than I am, but Dr. Pousti has kindly called, not once, but TWICE in the last few days to make sure i have all my questions answered, and my fears allayed. I am very impressed with the care and concern he has shown me, and I am sure, shows ALL of his patients. He encourages his patients to put together a poster of inspirational photos of breasts to guide him during surgery. I have been looking at pictures for weeks and I believe I have honed down my aesthetic to a certain size and profile. My poster reflects this. I think this is an ingenious communication tool! Dr. Pousti says going by implant size is misleading because body sizes and configurations so greatly affect how the implant sits on the body or under the muscle. I am excited and know this will go well. I am anxious to begin the healing process, and I know I am in good hands with Dr. Pousti!

Surgery was yesterday afternoon (12/17/12). I was...

Surgery was yesterday afternoon (12/17/12). I was surprised at how awake I was when I got home. The care at the surgery center was top notch. Dr. Pousti's team operated as a polite and professional, well-oiled machine. I always get really cold during and after surgery, and they had this nifty devise that blew how air into my gown and I woke up very comfortably. The aneisthesiologist was thorough and kind. IT IS A GOOD THING I went in for a revision as my right, twenty-year-old, silicone implant had EXPLODED! Apparently it was quite the war scene in there, but thankfully, it had been well-contained by my body's scar tissue. Dr. Pousti did a great job of cleaning it all up, but now I have a drain. I feel very fortunate that we found Dr. Pousti because of his vast expertise in all things breasts, and more importantly, breast augmentation revision. I can already see they look great! Much closer together and higher. I am pleased so far. I have posted a picture of the reality of surgery. We went OVER the muscle, and I am happy to find that I have no pain AT ALL this morning. I am supposed to keep my forearms close to my sides at all times as he did a capsulorrhaphy with the augmentation to keep the implants pointing more forward. I have a mountain peak for a sternum that points implants out to the side, so it took a little artistry to point them forward. Anyway, I am glad the surgery is over and now I can heal. I look forward to yoga in my distant future. Until that time I will follow doctor's orders and keep my elbows glued to my sides. I use tongs (or my husband) to reach most things.

6 Days out and I feel fantastic! SSOOOO glad I...

6 Days out and I feel fantastic! SSOOOO glad I went OVER the muscle! I read about the issue for HOURS! The best quote I read is from a female Plastic Surgeon from San Francisco, Karen Horton, she says, "Subglandular (over) placement avoids the motion deformity seen when implants are placed below the muscle." I like my pecs and I do not want to compromise their use for ANY result! I think that unnaturally stretching them to achieve an aesthetic "look" is really sad, at least for it is for me. I LIKE being a strong girl with full use of her muscles, I have worked so hard to develop them. I want to emphasize that I am NOT a bodybuilder, just a girl who likes being strong. So many of the after photos of unders never show photos of pecs flexing. I bet seeing those photos would change the minds of girls wondering whether to go under or over. Photos I see of unders are ALWAYS of relaxed boobs in a push-up bra. I have little breast tissue, but I think over can still give a better result with no compromise to functionality. I went walking today, with doctor's blessings. It felt great!

It is now January 11th and I finally took a good...

It is now January 11th and I finally took a good look at the results. It sort of felt like Christmas and opening a package kept under wraps! I am still wearing a bolster dressing on both sides. The dressings needed new tape to adhere properly, so I took photos in between. Because this was a revision, involving a ruptured and messy implant AND its clean up, I realize I am still swollen, and this is not the final result--by any means. I do hope, however, that my nipples come up some and point a little more forward. I also realize that given my anatomy, my nipples may always point to the side. I will just hope for the best and ask the doctor about it during my next appointment.

Updated photo at 35 days. Doctor Pousti told me I...

Updated photo at 35 days. Doctor Pousti told me I will see improvements all through this month. I am starting to look better and better. Swelling is going down from revision and skin is redraping over the new implants.

Nice job!

I am very pleased with my implants because now I have cleavage! I think they look very natural. The ONLY problem I have is a plasticky bubble in my right one that is not going away. I will talk to my doctor about this. I had gel implants. I wish they were softer like the original silicone I had. I hope they continue to strive to make implants like real breast tissue. I think they sacrificed some of that when they came up with cohesive gel. I am also SUPER glad I went OVER the muscle. My recovery was quick because they didn't CUT my pectoral muscles. I LOVE doing yoga and these muscles are important!
San Diego Plastic Surgeon

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