Arm Lit, Upr Body Lift, Brest Lift - La Mesa, CA

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I am 4 ½ years out from my Gastric Bypass (RNY),...

I am 4 ½ years out from my Gastric Bypass (RNY), currently I am prepping for my cosmetic Plastic Surgery!!! I have a 100lb weight loss.
I analyzed my the problem areas that bothered me the most on my body.
1. Belly/muffin top/lap apron. Whatever you call it, if I purchase pants to fit the waist-ish, butt and thighs. Then I look good however I have this muffin top that sticks out over the top of my pants and am back to wearing larger loose shirts to conceal. If I wear pants to not have the muffin top then they are falling off too big.
2. Back fat everything that hangs over the top and under the armpits around the bra area.
3. Breasts! The hang too low, I get tired of gluing (roll on medical adhesive) found out I’m allergic to Hollywood Tape to keep them in lace in my bra, mostly I just use rolled up socks to keep them in place (think back to a 12 year old girl)
4. Arms or as I call them my Bat wings. They are like a shiny object to me, when I get in the front row staring at the mirror at Zumba Class I get distracted! Watching them flap.
5. Thighs, these really don’t bother me too much as I never plan to wear micro shorts, bikini bottoms or anything that hits more than 2” above my knees.

7 week post op appt.

Thank you to everyone's comments and review, I hope my journey helps somebody else in researching for their surgeries and finding a Doctor.

Yesterday was my 7 week check up and I am pleased to say, my incisions are looking much better than my last appt. I am down to using just 1 4x4 gauze on each arm, under each breast and one in the center of my back. it is much easier to wash up I still cannot take a shower until they have all closed and the scabs are gone.
I still wear my compression sleeves and have some oozing, but Dr. Pousti seems to think I am doing fine. next appointment is in 2 months
San Diego Plastic Surgeon

In researching for plastic surgery, I looked at multiple web sites, asked a friend or friend of a friend etc., went to the American Society of Plastic surgery (ASPS) and American Society of Bariatric Plastic Surgery (ASBPS) web sites. I wanted as much information as I could gather for my specific problem areas. I made a multiple consultations (the majority of Plastic Surgeons will provide you with a free consultation.) After much research on types of surgery, Doctors, multiple web sites and here at I have decided on having, 1.) Upper Body Lift; cut on the back along the bra line to remove the extra skin that pushes up and over the bra under the arms breast area also known as spillage! With the removal of those pesky love handles. 2.) Breast lift MastopexyIII; without augmentation. At a later date augmentation can be combined with the lower boy lift if I don't like the results of just the lift. Allowing my breasts to heal completely without the added weight of implants. 3.) Arm lift; Removal of excess skin from the armpit to elbow (I also call this my bat wings!) 4.) at a future date 6 months or so a full circumferential lower body lift., this gave me more information on types and photos of before and after of the types of surgery I was interested in. Real Self had massive information on Board Certified Doctors, links to their web sites photos of surgeries. I crossed referenced doctors from this site based on the areas I was willing to travel to with the list I had from the ASBPS. I narrowed it to about 8 surgeons, went thru their web sites, read their reviews (got real good at reading between the lines on the reviews) picked the ones who seemed to do a lot of post Gastric Bypass patients.... off to the consultations. Do not discount the personality of the surgeon or their office staff!, if you feel uncomfortable in any way get out of there. believe me when you find the correct one, from the time you walk thru the door the staff should greet you with smiles and make you at ease. (remember they are the Doctor’s first line of Customer Service) , as you are going to be nearly naked in a few and there will be a camera involved along with a doctors hands all over your saggy parts! Here is why I choose the Doctor I did; Dr. Tom Pousti, in San Diego (La Mesa) CA. 619/466-8851 Based on he had 486 reviews and a 5 Star rating. (Believe me I read hundreds of those reviews) by the time I made my 1st consultation, I had gone through his entire web site. I had an appointment 1 1/2 week later. I was greeted with a smile, and offer of water of a granola bar, after about 5 minutes I was brought into an exam room dressed into a gown open to the front,. GULP. The Office staff put me perfectly at ease, explains what we would discuss with the doctor today, showed me some photos had me fill out a survey how I found him, when we checked the Real Self web site by this time he has 604 reviews and still a 5 Star rating. Dr. Pousti put us (my husband and myself) very at ease, he felt it was important to tell us about himself other than just his education. His marriage, children, family, where he was from, what he loves about what he does. We got an all around feeling about him. we discussed what I wanted, my problem areas and what bothered me the most. He is the one who suggested I do not do the augmentation at the same time as the breast lift as the healing process with the added weight of implants. Dr. Pousti explained that I may not need the augmentation as he can take extra tissue from the problem area that hangs out over my bra straps under my arms and insert it into my breast's to make them fuller (yippie) he can do all three surgeries at the same time, as this is alot at least 5 hours worth of surgery time. Another plus out of all the other Doctors I consulted with, Dr. Pousti’s office was the only office to have actual patients for me to see and speak with about their experience. I saw at least 2 patients each time I went into the office, I saw patients at 2, 3 and 6 weeks out from surgery. various stages of healing, scar width evenness of the incision and breast lifts all were impressive. I decided to go for it, on to the financing; I used my 401k for a loan, at 4.25% you can't beat it and I am borrowing from and paying myself back. I did consult with another Doctor in Upland CA I felt comfortable with him however he had no patients to talk to or see (view his work), and he wanted to break down my 3 surgeries into separate ones recovery time of 2-3 weeks each procedure(6-9 weeks off work). And regarding my lower body lift at a later date it would be done in 2 stages front and back. At 6 weeks recovery time for each total 12 weeks off work. This would be more expensive in the long run Surgery scheduled on JULY 3, 2014 0700 I had all three surgeries (Arms' Upper Body lift and breast lift w/o augmentation), at Physicians Surgical Center in La Mesa by Alvarado Hospital, Dr. Pousti's team is amazing, the nurses put you at ease, and customer care is obviously number 1. To tell the truth the only really painful part was the IV's in the feet, by feet I mean they did my right foot and the vein rolled and the nurse couldn't get it in, sooo she switched to the left foot got it partway in but the needle wouldn't go all the way and they had to stick me a third time. all I can say is WOW, the IV needed to go into my foot as due to keeping the arms free for the arm lift. My husband and I met the "team" as they entered the post op care it. Photos were taken as Dr. Pousti went over the "markings" from the night before on my body discussed and made changes with his blue marker! On the advice of Dr. Pousti I hired a nurse for the first 5 hours after surgery to help care for me in the hotel room. She also taught my husband about keeping my medication schedule, emptying my drains. She even sent him away to go eat while she was there to take care of me. Those first 3-4 days were a bluuuurrrrrr, good pain meds, lots of sleep, Dr. Pousti even came by the hotel that first night after surgery to check on me on his way home from work..... I stayed in a hotel down the road from Dr. Pousti’s office for 6 nights from marking night (the night before surgery) and checked out the morning after my 1st post op appointment. Dr. Pousti’s office called me EVERY DAY to follow up on how I was doing, again great customer service, caring people. The pain from what I remember is manageable, more major discomfort than pain except the arms, you do not realize how much you use your arms to get in and out of bed, til you can’t By the third day I was maneuvering around to and from the bathroom ok, my problem was getting into and out of bed, could not use my arms to lift myself up. Thank god for Zumba and squat challenges, I even texted my Zumba instructor and thanked her. Advice time, Pillows pillows pillows!!!! You sleep sitting up, pillows placed under each arm. Propped on your sides to keep you from tilting to the side. And you kinda walk like a Zombie in a B grade movie. July 7, 2014 First post-op day 4; First off Dr. Pousti told me my surgery was a success; I am going to be so pleased and showed me that even trussed up like a turkey with all the bandaging, he points out how smooth my area is from my hips up (love handles) I had my bandages removed on my arms ! SUCH a difference even with the swelling //insert photos here// Unfortunately they did not remove any bandaging from around my upper body lift or breast lift area. I so wanted to see my new improved boobies! My arms felt and looked so much better no bruising at all. The stitching was nice and even, straight line and I measured when I go home and there was a 3 inch difference in one arm and 3.5 inches in the other. And that was with swelling. The tape did irritate a bit no matter what kind I used and I changed the dressings twice a day sometimes. July 17, 2014 Second post-op day 14 Ok catching up I am 9 days out and have my second post op tomorrow ( it's like waiting for Christmas I get to be unwrapped!) so far all I have seen are my arms. Woooo hoooo the bandages on my arms, breasts and body lift areas (in other words the incision circling all around me) were removed! I have breasts! The nipples are 3 inches higher than they were (yes I measured). They are fuller and firm. My incision for the upper body lift starts right in the front center under my breasts it circles around my body and ends approximatelt 1 inch from the beginning of the circle. I no longer have love handles on my back, the tissue from under my arms the stuff that spills out over the top of my bra is now filling my breasts. My breasts are very firm I have swelling in that area. I am hoping not too much is swelling but Dr. Pousti, is pleased. My discomfort level at this time is much better mostly when I try to sleep. Or forget and reach for something. //Insert photos here// July 24, 2014 Third post-op day 21 Still wearing my surgical bra! It is holding the surgical pads in place. Some of my stitches were removed in my arms. They seem to be doing well the swelling has gone down much more. The rest of my stitches by my elbows and armpits as well as my back over the spine area are going to be left in for another 2 weeks as I go back to work at 25 days out from surgery. The swelling has gone down under my arms no more spillage over my bra! Even the swelling has gone down in my breasts, I was told if I wanted to walk around topless in the house to get some relief from the heat, trade in the surgical bra and wear a sports bra (NO Underwire.) August 21, 2014 Fourth post-op day 35 I was a little worried my arms look horrible the stitches left in were coming loose; there were gaps up near the armpits. yellow oozing, redness and very sore, still taking my pain meds as I need them. (this is normal according to the papers I read) changing my dressings twice a day, I was afraid that since I went back to work I was doing too much. According to Dr. Pousti and his staff they didn’t blink at the state of my arm, this apparently is normal. The skin under the arms is some of the thinnest on our bodies and do not take well to stitches. This is where the compression sleeves come in. I attempted to put them on 2 weeks earlier but the swelling was still too much and the pain and agony, phew. But Daisy just put new Xeroform strips and gauze with tape to cover the incision then rolled up the compression sleeves and hooked them together! No pain, I was relieved. As for the other incisions, my back and breasts, no discharge from the upper body lift minimal form the underneath of my breasts. They by the way look fabulous! The way I am healing is so surprising the scabbing is falling off and the scars are fading and will continue to get smaller based on what I‘m told and have seen. I only am allowing myself to drive 20 miles each way to catch my carpool, the gentlemen I work with have been taking great care of me, I even bought a new lunch box and carry a small wallet that holds driver’s license, credit card and medical card, this way they don’t get laughed at by carrying a girly purse and lunch box! They open the heavy doors and don’t let me reach or carry anything. They have been a terrific support group for me. All caught up! Today August 11, 2014 I have had to replace the Xeroform and bandages form my last post op appointment, after 4 days and the putting on and off of the sports bras have caused slippage and the Xeroform strips have dried out rubbing me raw. Today I removed the compression sleeves to wash and dry them out. I’ll put them back on later today. The bandaging from my last appointment have stayed put with no problem. My next post-op appointment is in in 10 days. Dr. Pousti told me I should be all healed by then. I trust this will be true and can restart going back to my Zumba classes slowly! So here is my review and suggestions; Dr. Pousti and staff 5 Stars Customer service / Patient Care 5 Stars Knowledge base of staff 5 Stars Time of employment of Doctors staff 5 Stars Surgical team 5 Stars Surgical Center 5 Stars Holiday Inn, La Mesa (Doctors discount given) 5 Stars Suggestions; Post surgical wear; large armholes, try 2XL men’s t-shirts, try thrift stores go for softest fabric. Washing your body; you cannot get the incisions wet! I’m still waiting for that day I’m 5+wks out. Take od towels and cut them into 4x4 squares to wrap around your finger, to put soap and water just where you want them. Keep an oscillating fan on while washing the bathroom counter, this helps dry you off . Check out my photos;

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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