Breast Implant Revision with Dr. Pousti. La Mesa, CA

I had my surgery a couple of weeks ago and wanted...

I had my surgery a couple of weeks ago and wanted to share my experience.
My initial BA was in 1999 when I was in my late 20's. I really was a size A or A negative if there is one since I weighed 100 pounds back then. I just needed a bit to fill out so my first implants were 325 saline. After 12 years and breastfeeding 2 kids later, in 2011 I wanted to increase volume since the breastfeeding drained my boobs and they looked very awkward. Plus I wanted no rippling. Got a new set of silicone implants 640cc low profile. I liked the size but because they were the classic Mentor low profile they looked like pancakes then full round perky boobs. But I wasn planning on keeping them for 10 years and change out to high profile.
Then in mid 2015 I noticed my right breast would sit up high almost near my neck esp after underwire bra for a day and that continued on and off for months. I thought nothing of it. The left breast, meanwhile, kept falling down or bottoming down. Again, I did not know anything about capsular contraction or bottoming out issues and I didn't know much until I went to a couple of doctors and they said it looks like right breast had capsular and left breast needed pocket revision. I was devastated.
I had read about Dr Pousti on RS many times before on girls having their first set of breast augmentation but now after hearing this, I started researching him and saw that he does a lot of revisions for these types of issues. I drove 2 hrs to have consultation with him back in October 2015. He was even better looking than his pictures here on RS. A charismatic person and very humble person. He told me what the other 2 docs said that I would need capsulectomy / capsulorraphy (words I cannot pronounce) which basically is internal pocket repair and bilateral repair of both sides to remove any capsular and repair my breast pocket so that the implants can stay in place. His quote was not too far off from the other doctors. The fact that he is 2 hrs away means a lot of commuting for me during post op but since I needed to get the revision done, which at that time, the breasts were starting to hurt esp w the right breast. I put a deposit down and secured a date for December. I have never done anything like that before with any of my surgeries where I didn't at least spend a week thinking about it before selecting that surgeon. With Dr Pousti, his professionalism and his work based on his website and the reviews here just sold me that very day at the consult.

At my pre-op a few weeks before surgery I meet with Dr. Pousti again and Vanessa his office manager and we discussed goals and expectations. I was very honest that since this is my 3rd time and hoping final time I wanted high profile perky and stay within my current size but if I needed to go down to 550cc so that the pocket doesn't pop open or capsular happen again I would be willing. But I preferred the 600cc HP round. We looked at pics of other patients in his office. He then brought up Allograft which is something I have not heard before. I heard of Strattice or mesh from my other consults but they didn't think I needed it. Now with Allograft it is even more expensive and the idea is it helps support the internal breast pocket revision and enhances how the implants look, reduces rippling or tenting effect. My implants were low profile so they were almost touching my mid line and I would need reinforcement in that area as part of this revision. He had me talk to a couple of other patients that had the same procedure done recently which I thought was very helpful to make a decision. Still because of the price for Allograft I hesitated and decided to think over a few days.
I researched on here for revision with Allograft and found just a few and they seem to be happy w their decision.
I called the office a few days later and agreed to do it. Hoping for this thing to keep my breast perky and prevent any future capsular.

Day of surgery
I drove down the day before surgery and stayed in town for 3 days. The morning I took a taxi to Alverado Surgical Center for my surgery. It is a really nice center and is just down a few buildings from the big hospital. I liked that if anything goes wrong which is normal fear of surgery of course that they can transport me to the hospital. The team at the surgical center is great. Heather from Dr Pousti's office met with me after I changed into surgical gown and we discussed goals more. I honestly got more opportunities to discuss goals than I would say my last 2 breast surgeries combined. That's how caring and serious he is about his patients to make sure to achieve their goals with realistic expectations. As you can see my pre-op pic I have some asymmetry and I said that is my #1 goal in addition to removing the capsular. I brought more wish pics and told Heather 600-650cc HP but would be happy with 600. Then Dr Pousti came in and marked me with his famous red and purple and blue markers which to this day at 2 weeks post-op typing this review, I still cannot remove all the purple marker off esp since you can't shower as long as you have all these bolster dressing on. I'll talk more about these dressings later.
Anyway, I always like a dr that marks his patients up which makes me feel confident he is detailed oriented and thorough about what he is going to operate on. Maybe I'm just nitpicking but always wonder if they remember which boob has which issue to correct once you go under...if they don't mark it up ????.

I was told the surgery would take 4 hrs or more but I got done in 3 hrs. All I remember was I woke up and the nurse said it's done and I feel like I just went to sleep seconds ago. No issue w the anesthesia when I told them I always get the shakes coming out of anesthesia so please do what they can to prevent. No shakes at all. No pain either since they gave me pain in my IV. Dr Pousti walked by and I asked greedily how many cc and he said 650cc and I was so happy and fell back to sleep.

An hour later I was released. My sister picked me up. I had no major pain as I had expected for both pocket revision. In fact I was up the rest of the day walking around the house watching TV. It was almost as easy as the second breast augmentation. Pain for first BA was a 10 like a truck hit you. Pain for second BA was a 4. This one was a 5 which is tolerable with Percocet. I took the pain meds instructed every 4 hrs but I could not sleep well w Percocet and it would give me a migraine, so I quit it by Day 2 after surgery. I just took 2 extra strength Tylenol every 6 hrs from day 2 to day 10. I have not needed anything since there's not much pain since.

The Itches drive me insane!

Yes with the tape to hold the dressing under each breast as well as the cleavage area, and I was told it stays on for 5-6 weeks with the surgical bra on, until Dr says I can remove them. Well I have always had skin allergy to anything constricting and the glue from the tape also causes me to rip it off by day 5 and replaced with a cloth tape I bought from Amazon. Needless to say that doesn't help either. So I took antihistamine to go to sleep so I wouldn't scratch. Well in the morning I wake up with broken skin for scratching the itches in my sleep. Oh did I mention I had 4 drains..2 on each side. Those things were so hard to hide even under big jacket. The bulbs that the drainage go into are the size of a grenade. Where those bulbs rubbed against my skin I scratched like hell. Anyway I got the drains removed at day 10 by Daisy she was very good at not hurting me when pulling it out. She even extra numbed me.

So I would say the hardest part of this recovery is the damn itchiness which I now have to air out my skin about an hour a day to let the raw skin heal. I bought new dressing from the pharmacy and changed them this week. Daisy from Dr office would call every day to check on me, which is so sweet. When I told her I took off the dressing and changed to new one and taped myself back, she wasn't too happy with it. I cannot believe any girl here has not have the same itch monster as I have and dutifully keep their bolster dressing in all place intact from the day of the surgery until 6 weeks later. If Dr Pousti is reading this he will kill me at my one month post op...he will say I mess up my results which I'm worried but I really am going crazy with the rash and I take so much antihistamine that I'm so dopey at work. And I sleep with a bottle of hydrocortisone on each side my body so I can apply it in the middle of the night.

The other hardest part is keeping your arms close to you like T-Rex. I tried but it's hard esp when every thing you do even putting on clothes you have to use your arms and move them. But this I will comply as much as possible.

As far as my new breasts, it's too early to tell as they change a lot each week and I'm about 2.5 weeks out. They do look a lot better than before. They don't feel as high as I thought higher profile would look but again it's too early to tell. They do seem symmetrical but not 100%. Dr Pousti already advised me that no 2 breasts look identical. Breast are sisters not twins...or something like that. So I will be patient as the full results aren't until 6-12 months. So far I like them though. I'm the only one that sees them. The guy I was dating for a while broke off w me the day I asked him to come and help change my dressing tape. Very sad as it was the day after Christmas. I'm just going to focus on taking care of myself and can't wait to be in a bikini Ina few months.

I will post more pics at my 1 month post op. I can't wait to see Dr Pousti again!

Breast Implant Revision

Here is my 2.5 week po pic.
The red is the rash from my scratching.

I bought a thong bra a couple of days ago and I wear it with the dressing underneath, and then the surgical bra on top of the thong bra. It's really giving more compression to the sternum area.

Not sure if this pic comes through. Doesn't seem to load from the iPad so I'm trying again from my phone.

4 weeks po

I had my 4 weeks po appointment last week. Got to remove the dressings and the tape around the areola. I was too scared to look at the incision. Dr Pousti said I don't have to wear surgical bra anymore but I have to keep wearing the thong bra as much as possible. And I can wear sports bra. The breasts look better each week.
Here are pics from my dr appt. I have a red rash on my right boob from scratching so that should go away in a couple of weeks.
My next appointment is at 3 month post op and I will update again.
San Diego Plastic Surgeon

A well run office. I've been in enough plastic surgeons office and know while the skill of the surgeon is utmost important, it is how the office staff interact with patients before and after that's crucial for me. Everyone is professional. I get to talk to Dr Pousti several times when I called and never get the run around. He's very honest with his opinion and he listens to you. No question is stupid. I am impressed with everyone here.

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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