This 47 year old male patient from Chino Hills, California had massive weight loss (lost about 98lbs) after Lap Band surgery and was left with a moderate amount of excess skin around the abdominal wall. He found Dr. Pousti while searching for a board certified plastic surgeon and was impressed with his experience with abdominoplasty surgery as well as surgery after weight-loss.

The day prior to surgery the patient meets with Dr. Pousti in the office for markings. During the markings appointment the patient has a chance to see where the scars will be and also to ask Dr. Pousti last minute questions. The markings are gone over with the patient in a full-length mirror. The incisions and exact procedure are reviewed with the patient as well.

Markings are performed and show where liposuction will be performed during the tummy tuck procedure.

Above, you can see the port that was placed during the Lap Band Surgery. The port will still be functional after this tummy tuck procedure.  Once the patient is in the Operating Room, additional markings are made to show where the muscles will be brought together to create an internal corset resulting in a desirable waistline.

In OR after muscle repair is performed

After the muscle repair is completed the excess tissue is removed from the abdomen using cautery. A new location is made (in the skin) for the umbilicus and the incision is closed with dissolvable sutures.

This 43 year old patient from Fallbrook, California had been interested in a complete mommy makeover for quite some time after multiple pregnancies and weight loss left her with extra skin.  She wanted her breasts lifted and the asymmetry corrected as well as wanting the excess skin and adipose tissue around her abdominal area and lower back removed completely.

The excess skin under her armpits (axillary tissue) was also a concern for the patient and decided to have this skin removed as well.

She and her husband went online to do research to find a Southern California Plastic Surgeon for her procedure. They were both extrememly impressed with the experience Dr. Pousti had performing mommy makeover procedures.

Being unhappy with her body, she decided to fine the best plastic surgeon to take care of her. She wanted a Board Certified Plastic Surgeon with lots of experience with mommy makeovers. Safety was a concern for this patient and she wanted to make sure whoever she chose, would be performing the procedure in a safe setting with the credentials to perform cosmetic surgery.

After examination of the patient, Dr. Pousti discussed breast lifting as well as breast reduction surgery, removal of the axillary tissue at the same time, and extended tummy tuck.  The extended tummy tuck and flank lipectomy will help improve the patient’s contour of the back and take care of the “muffin top”.  Liposuction would also be performed but only to the extent that was safe.  The patient was happy with her meeting and the procedures that were going to be performed so she proceeded with scheduling surgery.

Markings were performed the night prior to surgery.

The breasts were measured and marked accordingly.  The “x” marks the new position of the nipple/areola complex after the breast lift / breast reduction is performed.

The abdomen and back were also marked and all of the procedures were discussed one more time with the patient and her husband.  The excess skin and tissue from her belly button down to her pubic area will be removed completely. The area in purple on her back indicates the tissue that will also be removed (the “red” line is where the final incision will be).

In the operating room, the patient starts off laying prone (on her stomach) so that the back can be worked on first.  After the back is completed, the patient is then turned over to work on her breasts and abdomen.

Dr. Pousti removes the excess skin and adipose tissue of the back/flank area (back lipectomy) and then performs liposuction to improve the contour of the back area prior to suturing things together.

Dr. Pousti will now start working on the patient’s breasts.  She wanted them reduced in size and “more perky” so a breast lift / breast reduction was performed.  Here you can see  1 side is completed and what a dramatic difference there is between the two breasts. No breast implants were placed for this patient.

The areola size is also reduced during the breast lifting surgery to improve the aesthetic results.

The abdomen is opened and the abdominal muscles that have separated are located (the clamps above).  The abdominal muscles are then brought together and sutured together to give the patient the “tight tummy” she wanted.  Above you see the dark lines running up and down that are separated and below those muscles have been sutured together (one line running up and down the abdomen).

The excess skin will now be removed (the triangular tissue below).

The excess skin is removed and then multiple layers of closure are performed to close the incision line.

After Mommy Makeover

Swelling will subside after a few months, but the patient must take precautions to daily activities for the first month and moderate activity the following months until completely healed.

For the past several years I had been looking in the mirror and becoming increasing unhappy with my appearance. I had substantial weight loss of fifty pounds when I was a teenager, a twenty-something, and after the birth of my children. I smoked for more than 20 years in an effort to lose weight and keep it off. That worked but it did no favors to my skin. Genetics weren’t on my side either. I began to notice that I had the same jowls and pouches as my father and the same sagging neck as my mother. Mind you, I have been taking care of myself physically for many years. I had quit smoking, I ate a healthy diet, and I exercised. But these were things that all of those lifestyle changes could not repair. I decided that I was going to have cosmetic surgery.

Not knowing anyone who has had any cosmetic surgery here in San Diego, I did a lot of research online. I looked at procedures, read blogs, and most importantly, looked for the best cosmetic surgeon. I decided that I would get opinions from five doctors. I visited the first two who each had his own idea of how much surgery I would need to look natural and for everything to blend. Although the first one was very nice, I just didn’t feel the right connection, the trust, for surgery.  I felt the second doctor was a little too aggressive with what he thought would look right for me. Both doctors showed me albums of pictures of previous patients. When I requested to speak to one, though, they avoided a direct answer to me.

Dr. Pousti was my third and last doctor. After the evaluation, I was able to speak to several patients directly. For a patient to be willing to speak to another patient about such a private matter was very persuasive for me. I was so impressed and felt so comfortable, I went home and told my husband, this is my doctor. There is no need to go anywhere else, this is the man that I trust to do what I want done and I was confident that I would be pleased with the results.

Pleased does not begin to describe how I feel about the results. The jowls are gone, the pouches are gone, and the saggy neck is gone. I didn’t want to look 20 years younger, I just wanted to look a better me. I wanted it to look natural and it does. My friends and relatives are amazed at the results. Everyone says the same thing: “Wow! You look fantastic. It looks very natural.”

The entire process has been amazing. Dr. Pousti is an exceptionally talented surgeon, a warm-hearted and caring person who is genuinely concerned with his patients. After our first conversation, I knew he was committed to do his best for me to achieve the results that I wanted. Dr. Pousti brought back my confidence. I no longer feel old looking. I look like a woman who takes care of herself. It is a look that I deserve to have and Dr. Pousti gave it to me.

This would not be complete without mention of Dr. Pousti’s wonderful staff. I am so impressed with their knowledge, professionalism, attention, and friendliness. They followed up with me daily after the surgery, making sure that I was feeling ok and answering any questions that I had. I had support the entire time during my recovery. That was very reassuring to me.

I plan to have another cosmetic procedure in the near future. Rest assured, Dr. Pousti will be the surgeon doing the procedure.

NC

San Diego

We had so much fun at our previous CoolSculpting Event, we are having another one!

Pousti Plastic Surgery is pleased and excited to announce the practice’s adoption of the innovative CoolSculpting fat removal technology for patients desiring fat removal without the cost and recovery associated with traditional liposuction. Pousti Plastic Surgery is one of the first medical and cosmetic surgery practices in the Southern California region to offer this breakthrough in non-invasive fat reduction.

CoolSculpting is an exciting and innovative new approach to non-invasive fat reduction. “This technology has demonstrated significant positive results in clinical studies for removing unwanted body fat without the possible risks and recovery of invasive procedures” said Dr. Tom Pousti of Pousti Plastic Surgery in San Diego, California. “This fat-reducing technology is particularly effective in resistant localized areas of the body such as back fat, love handles, and isolated belly fat. The CoolSculpting procedure is extremely comfortable and patients are very satisfied with the process and results.”

Cleared by the Food and Drug Administration (FDA), the CoolSculpting technology works by gently cooling unwanted fat cells in the body, inducing a natural and controlled elimination of fat cells. CoolSculpting is based on scientific discovery from the Wellman Center for Photomedicine at Massachusetts General Hospital in Boston, Massachusetts. The research proved through vast research that fat cells are more susceptible to cold and are selectively, painlessly, and permanently destroyed.

Several weeks after the procedure, cooled fat cells begin a process called apoptosis and start to shrink and disappear. The patient begins to naturally and gradually eliminate cooled fat cells, thereby reducing the thickness of the fat layer in targeted areas of the body.

Unlike other harsh fat reduction or removal procedures, CoolSculpting requires no needles, surgery, or recovery periods. During the procedure, a non-invasive applicator delivers precisely controlled cooling to the treatment area. Treatments last between one and two hours, and patients have the option for additional treatments for more substantial effects if desired. Each CoolSculpting procedure results in an undeniable reduction of fat in the treatment area, and patients see results as early as three weeks following treatment. The most dramatic results occur over a period of between two and four months in most patients.

I am a 41 year old and have been fighting my weight gains and losses ever since I was 23 years old. In high school I thought I looked okay. It wasn’t until I married and had 2 children that my weight problem got serious. Every year the pounds just kept adding up until I was at 265 pounds and didn’t know how I got there. I tried many different weightless programs, and always seemed to put the weight back on just as fast as I lost it.

After 2 years of hard work at the gym and watching what I ate, I managed to loose 80 pounds, which left me with what I called my “skin tutu” around my middle and my breast hung down to my waist, which my kids referred to as my “cuddle buddies” because they laid on the bed next to me.

The more I lost the worst I looked! I wanted to love the body I worked so hard to get, but that isn’t what happened. The skin would just hang worse every pound I lost I wanted to love my body.

I started looking on the Internet at “mommy makeovers” before and after pictures, and at people like me who lost a lot of weight, and wanted the skin removed. I would say for every 10 women that I found, that I looked like in there before pictures, and loved their after pictures, 8 out of those 10 women were done by Dr. Pousti.

I looked at before and after pictures for at least a year prior to my surgery, wondering if I should do this or not. I was scared of what was involved and how I would look after. I didn’t want to look like one of those women who have surgeries and look worse afterwards.

Well, with the love and support of my fiancé, my children, my parents and my friends, I decided to make an appointment for a consultation with Dr. Pousti.

The day of my consultation, my fiancé and my mother came with me to my appointment. We went to Dr Pousti’s office in Murrieta, Ca. The moment I walked in, it felt so right. The women who work there were not just stunningly beautiful on the outside, but on the inside. They made me feel so comfortable and at ease! Dr. Pousti came in and looked at me and said he thought I would have amazing results. He suggested having an extended tummy tuck and a breast reduction, with some liposuction.

I weighted in at 207 and knew I had more weight to lose. I wanted to have this surgery in January when my business is slower. Dr Pousti suggested that an ideal weight he would like me to be for surgery was 180 pounds. Well, I was within a few pounds of my goal when surgery day arrived.

About 1 month prior to my scheduled surgery, my fiancé found out he had Thyroid Cancer. I wasn’t sure if I should cancel my surgery with Dr. Pousti. When I came in to see Dr. Pousti he could see I was nervous about my fiancé’s news. Dr Pousti asked who the surgeon was and he personally called every ENT Dr. That he knew to see if anyone had heard of this surgeon, and what his experience was. He called me personally the next day to tell me of his findings. Dr Pousti didn’t have to make those calls, but he did, and that meant the world to me. He doesn’t just care about me, but also about the man I love. My fiancé had his surgery and it was a success!

The day before my surgery my fiancé, and my mother came with me to Dr Pousti’s office in La Mesa ca. He did all his markings of what was going to remove, where he would cut and where he would lipo. He marked my breast so I would have my best results.

We stayed at my aunt’s house ,which was close to the surgery center, and is where I stayed for the first week after surgery. My mom was my nurse for the first week! I can’t thank her enough for helping me. I stayed at my aunts because Dr. Pousti wanted me to stay close by so he could check on me post surgery.

The day finally arrived, and we arrived at the surgery center. Dr Pousti uses the same surgery center, with the same anesthesiologist and the same nurses and assistants. I was so scared and everyone calmed me and made me feel comfortable and so special. They were very professional, and they had a way of making you feel like you were their only patient! Dr Pousti came in and checked his marking and did some minor adjustments,and then they took me back to the operating room. I woke up 8 hours later 6 hour surgery 2 hours of recovery, and I felt like I just got there.

The feeling I had was the feeling of tightness! I’m not going to lie week 1 was the hardest week but it was worth it! He installs a pain pump that numbs the incision area. I had 4 drains 2 from my breast and 2 from my pelvic area. They sent me home the same day of surgery. I really don’t remember too much as I was still really groggy.

I stayed at my aunts house and slept in a recliner for the first week. Dr Pousti and his wife  were so kind to check on me the first night after surgery! They even brought me flowers! Never have I heard of a Dr. doing this before. The compassion and love he has for his patients is very apparent! He has always made me feel like I was his only patient, and his # 1 priority, even though I know he has many more patients.

The nurse or office staff called me everyday to check on me! Everyday was easier than the day before. I got around with my trusty walker, my BFF after surgery!

Dr Pousti told me that after surgery you go through an emotional state, but what found was not what I expected at all! I was expecting tears of pain and thought of regret, but that isn’t what I had at all! I never once thought why did I do this? The emotions I felt were eye opening to my life! The tears I shed were tears of love and joy and how lucky I am to have parents who took care of me for 6 weeks, a fiancé who supported me, no matter what I wanted to do, and my daughters, who stood by my side the whole time. Then the flowers, the cards, and the text messages came from friends, and clients thinking about me. The love I felt was overwhelming! Every tear I shed, were tears of joy of my life, my new body, and my new life to come!

This whole experience was the best thing I could have ever done! The most important thing is I truly feel like I was led to Dr. Pousti, and the results I got are amazing! He is a true artist of the body! He knows what will look the best and what is needed and not needed. He doesn’t just make you feel like he’s just your surgeon, but your friend, with your best interests in mind! The surgery is going to change my life for the better, and can’t thank him enough!

This 29 year old patient from San Diego, California had gone through massive weight loss and was left with excess skin. After proceeding with extended abdominoplasty and breast lift with Dr. Pousti previously she knew she wanted to return to him for more procedures. She was interested in  breast augmentation, thigh lift, and liposuction of her outer thighs.

The patient lost a combined total of 122 pounds but was left with sagging skin. Because she had so many areas that she wanted to work on Dr. Pousti felt more comfortable doing her procedures in two stages. After healing from the first stage she was ready to begin the thigh lift, breast augmentation and liposuction portion.

The patient and Dr. Pousti meet several times prior to the surgery to discuss the procedure and the patient’s options. On the final meeting before the surgery measurement are taken and markings are made. These markings are used as a guideline for Dr. Pousti in the operating room.

During the thigh lifting portion of the procedure liposuction is used to couture the thighs then incisions are made and excess tissue is removed.

Below, you can see the fat after liposuction has been performed on the outer thighs.

Dr. Pousti used Smooth Round MPP Silicone Gel Breast Implants filled to 600cc on the right and 550cc on the left. The left breast was slightly larger than the right, so the right breast has a larger implant.

The patient is extrememly satisfied with the addition of her breast augmentation, thigh lift, and liposuction.

You ask me for my story and I ask – which version should I tell?  How much of the heartache, disappointment, and self-deprecation do I focus on?  Or do I focus on the great joy, love, achievements and success I have experienced?  The later certainly has outweighed the former. So why have I focused and put more weight on the former? No pun intended.

As a child I was raised in a family with much love, excitement, chaos and food. Being one of 12 the challenge was to be noticed and of course liked.  I remember being the designated baker and would bake all of the birthday cakes or other treats.  “If I do this they will like me”, I would rationalize. Continuing this practice I would try to woo friendship with cookies, cakes, etc.
While I was not an unusually large child I matured early and therefore quickly stood out as much larger than my siblings or friends. So in my mind, I was “fat”.  I tried a litany of diets and plans to become what I believed was the right size.  Thus began the roller coaster in my weight. Throughout college – thinking “if I just lose weight, I will have boyfriends, friends, be popular”.  Then when it didn’t materialize after the weight loss I would say – forget it and gain it back.  Depression followed failed attempts and what a great friend food is – it’s always there and at least temporarily fulfills only to be followed by depression which of course was followed by more food.
In my early 20’s I was blessed to meet my husband – a wonderful godly man who loved me regardless of my size.  I always promised myself I would not be heavy in my wedding pictures and successfully lost weight and at least for a few days I was at my goal weight at 135lbs.  After the wedding I continued my roller coaster and my weight went back up topping out at 228.  In addition to the extra weight I had 4 c-sections leaving my body an embarrassing blob.
The year I turned 50 – I decided it was time to take charge.  I hired a personal trainer, lost 50, ran a half marathon and changed my habits.  At that point I decided that the greatest gift I could give myself was a healthy lifestyle and being a good steward of the great health my genetics offered me.  At that point I decided to visit Dr. Pousti and improve my body-image even more.  I have been thrilled with the results – as has my husband.
In no way is this the solution to a life of roller coaster rides but it has moved me closer to being who I believe God created me to be.  So the life of heartache, disappointment, and self-deprecation…it will always be an excerpt in my life but I have chosen for it to be a footnote instead of a key chapter. I’m choosing, instead, to write new and revised versions.  I have been blessed, loved, cherished and that is where I choose to live.
Thanks for you and your incredible staff playing a part in this new edition.

This 29 year old patient had lost a significant amount of weight and was left bothered by her excess abdominal tissue. After completing the hard work of actually loosing the weight, the patient decided it was now time to feel good about herself. She was interested in finding a Plastic Surgeon serving the San Diego area who had extensive experience with patients who had extreme weight loss and found Dr. Pousti’s website.

The patient was not able to diminish her extra/loose skin with exercise. She was bothered by the “droopiness” and unevenness of her breasts, she wanted them more “perky” with the areola placement improved. She and Dr. Pousti discussed how patients who have had massive weight loss have skin elasticity issues and caution must be taken during surgery to achieve their goals.

Although the patient wanted breast implants in addition to breast lifting surgery, San Diego Breast Surgeon Dr. Pousti recommended that things be performed in 2 stages for safety.  The first surgery would include the breast lifting (mastopexy) surgery as well as the extended tummy tuck (abdominoplasty with back lipectomy) and after things have healed, they would perform the breast augmentation portion of the procedure.  The patient was happy with the Breast Surgery Experience of San Diego Surgeon, Dr. Pousti and proceeded with surgery.

Markings and measurements were performed the night before surgery, while Dr. Pousti explained the mastopexy and extended abdominoplasty procedures in detail again with the patient. Very precise measurements were taken for both procedures to ensure as much symmetry as possible.

All measurements are re-checked the morning of surgery prior to the start of the procedure.

In the operating room, after the back lipectomy is completed, the patient is turned onto her back so that the breast and tummy portion of the surgery can be performed.  Below you can see the right breast is being worked on and how nice the placement will be compared to the left breast.

The excess skin that will be removed during the tummy tuck procedure is shown below.

Immediately after surgery.

This 57 year old patient from Winchester, California had unwanted skin in her abdominal area after a significant weight loss. After her Massive Weightloss, she was interested in body contouring and was looking into Tummy Tuck Surgery.

Her body proportions left her unsatisfied and she felt a tummy tuck surgery would improve her abdominal section.

The night before surgery, markings were performed and are then reinforced and checked the morning of surgery. Dr. Pousti checks and re-checks the measurements to guarantee symmetry for the patient.

While Dr. Pousti performs markings, he will also discuss the procedure again with the patient to make sure the patient understands the tummy tuck procedure.

In the operating room, you can see the extent of excess skin, which will be removed from the abdominal area.  Recovery can take up to one year (for swelling to subside and for the skin to re-drape).

I’m 40 something, not sure anymore, always say I’m in my late 30’s. I had Gastric Bypass 18 months ago. I’m very happy with the results, but it left me with nothing (I mean nothing) up top. I had always thought I would never have plastic surgery, but now, I’m so happy with my results. I’m a professional so I did not want to look outrageous Monday –Friday and wanted my suit jackets to fit. However, Friday, Saturday and trips to Vegas are a different story.

Dr. Pousti, gave me the gift of both, professional female and daring diva (SNAP)! Before seeing Dr. Pousti. I was wearing 3-bras 2-Fredericks of Hollywood bras and the double padded Victoria’s Secret bra (yes one on top of the other) just to have a normal look. I was a 34 A, I got 600cc’s Mentor and am waiting where I will end up. I think somewhere around a 34DD.

Dr. Poustis’ team is fabulous, so very caring, you feel like a person all the way through the process. The day of surgery I felt so relaxed, I knew I was in good hands. I was the first surgery of the day, I was being prepped by the Pousti surgical team and Dr. Pousti arrived at the surgical center. A voice came over the PA….”Dr. Posuti has arrived”, there was cheering going on throughout the center. They were all so proud of him, I felt honored to have him as my Dr. It made me smile and feel happy that I put my health in the best hands.