Bottoming Out Revision Surgery
Bottoming Out Revision
Article and Photos by Dr. Tom Pousti
This 26-year old patient was interested in breast implant revision surgery and breast reconstruction with the use of AlloDerm dermis for increased coverage and support. The patient’s surgical history was extensive. She had injections of silicone gel into the breast in 2001 –this procedure is still experimental and not FDA approved in the United States. In January 2009, the patient had the silicone, which was previously injected, removed from her breasts, which required that almost 95% of her breast tissue be removed as well. She was left with no breast tissue and very thin skin. In the same month, the patient had breast augmentation surgery with saline breast implants performed by a surgeon in Los Angeles, which left her with rippling and other complications. Within the same week, she had breast augmentation revision surgery with the same surgeon; at this time the surgeon overfilled the saline implants to attempt minimizing of the rippling. The patient complained that her breasts didn’t “look like breasts” and were round, fake and asymmetric.
She urgently researched for a Board Certified Plastic and Reconstructive Surgeon to perform her revisionary breast surgery and after reading through many testimonials and reviews of post revision surgery patients, she decided that Dr. Pousti was the best surgeon to help her with her problem.
After several consultations via e-mail and phone conversations the patient decided to fly into San Diego to meet with Dr. Pousti.
The patient was in need of reconstructive surgery, her previous breast implants were causing her skin to stretch and separate.
Understanding her concerns about rippling and her skin being too thin to hold such a large breast implant, Dr. Pousti discussed using AlloDerm and reducing the size of the breast implants.
Markings were made prior to surgery and then re-done on the operating room table.
Dr. Pousti sits the patient upright during markings to achieve the most desirable look possible and also makes sure all measurements are precise. In order to achieve her desired look, Dr. Pousti removed her current saline breast implants, performed internal sutures, an “internal bra” was created, to repair the pockets and therefore correct the breast implant placement on her chest wall.
Measurements were carefully made for the placements of the internal sutures, and the use of AlloDerm.
AlloDerm tissue was used to reconstruct the areas where the her skin was thin and needed more support.
New 375cc smooth, round, moderated plus profile, silicone-gel breast implants, made by Mentor Corporation.
Photo above depicts patient prior to surgery and 6 months after surgery.