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Case of the Week #2

This 34 year old school teacher from La Mesa, California came to see San Diego Cosmetic Surgeon, Dr. Tom Pousti for a "make-over". After having 4 children, this patient was unable to lose the excess skin and adipose tissue of the abdominal area, and the inner and outer thighs. Her breasts had lost their fullness after breast feeding her children. She had many visits with Dr. Pousti and was comforted by the fact that Dr. Pousti is a double board certified Plastic and Reconstructive Surgeon.

She decided to proceed with bilateral breast augmentation, breast lifting, abdomioplasty, and liposuction of the lateral and medial thighs. She understood that these procedures could be performed at the same time ONLY if Dr. Pousti thought it safe to do so

The night before surgery, she came into the office for "markings". This is when Dr. Pousti takes about 30 minutes to an hour drawing on the patient and discussing where the incisions will be and how everything will be moved around. These markings are essential for a smooth surgery.

Before 1                                              Before 2

The surgery day: March, 2006. Before entering the operating room, the patient meets with Dr. Pousti once again to review all of the procedure one more time. Any questions or concerns will be addressed.

During the surgery, Plastic Surgeon, Dr. Tom Pousti works with his highly trained team in the operating room to achieve the goals for this patient.

First, the breast augmentation and breast lifting procedures are performed. Extreme care is taken to preserve the blood supply and nerves in the area. This procedure will give her breasts the look she had prior to childbirth and breastfeeding. She has 420cc saline implants placed under the muscle

The abdominoplasty procedure is next. All of the excess skin and adipose tissue is removed, as well as the damaged skin around the abdominal area, leaving the patient with a very "tight" tummy. The patient must take care to protect the incision for 2-4 weeks after the procedure.

Lastly, the liposuction of the outer and inner thighs is performed. Care is taken to remove equal amount from both sides to achieve symmetry after the procedure.

The patient followed up in our office for her post-op care. Care is taken to make sure that all incision lines are healing and that there is no infection present. The drains that are placed during the surgery to help with fluid accumulation have been removed (on average, they are placed for 1-2 weeks)

During the recovery period, the patient must take care to protect her incisions and not to overdo the activity. Around 4-6 weeks after the procedure, the internal sutures begin to dissolve and therefore it is critical to limit the activity to prevent wound healing problems.

Here she is only weeks after her breast augmentation/breast lifting, liposuction and abdominoplasty surgery:

Three Weeks After                             Three Weeks After

During the first couple of months, there is a lot of healing that the patient will undergo. She will have to protect the incision and stay "hunched over" for a while. As time goes on, the patient will slowly stand up straight and resume her normal activity. The swelling will decrease and the incision lines will improve (become thinner and less red)

Before                                                  5 months After

Before                                                   5 months After

PATIENT'S TESTIMONIAL:

I want to start out by saying, "If you are pondering between what doctor you want to perform your surgery, look no further". You have found him. Dr. Pousti is unbelievable. I can say this because I did my homework and 'shopped' around (5 doctors) and my heart led me straight back to my first consultation doctor, Dr. Pousti. I knew it all along, but, I wanted to dot my i's and cross my t's.

I had a Mastopexy/Breast Augmentation, Tummy Tuck and Liposuction of my medial and lateral thighs.

I am a busy mother of four very young children (6 & under) and am a full time Physical Education/Aerobic teacher. I workout 3 to sometimes 5 hours a day and nothing was going to bring on larger, firmer breasts (the sagginess was due to nursing all four children in 5 years) or take away the loose skin and the protrusion of my stomach from the laxity of the muscles in my abdominal region. And for the thighs, well, there was just a small amount there that my exercise was not taking care of.

I struggled with it all after having my last child, which just happens to be my only girl. I took a huge leap and decided to discuss the procedures with my husband. It's not like he did not know I was interested, as I watched Dr. 90210 all the time and hinted about what I would like to have done. Of course he thought I looked great the way I was, but when it came to discussing the matter, money really was more of the topic.

Most average working Americans don't have thousands lying around (at least not those with four children I presume), but my husband knew I had worked so hard baby after baby and from the mouth of Dr. Pousti, "No matter how hard she works out, she will not get rid of the tummy problems". That convinced him, as he has a tremendous regard for Dr. Pousti. On that note, I took my husband to most consultations with me and bar none, he was most comfortable with Dr. Pousti.

I have read a lot of testimonials and I agree with all of them. "You are not just another person with Dr. Pousti and his staff". When it is your time, you are his priority and post-op visits are no different. You are greeted with respect and dignity the minute you walk through his doors and that is QUALITY business if you ask me.

My surgery was quite lengthy (~6-7 hours) and I put all my faith and trust in Dr. Pousti. I can say that I was honestly NOT nervous, because number one it was him performing the surgery, and (no disrespect intended here Dr. Pousti) I knew I was going to be able to actually rest with a wonderful excuse and not have to be the one waiting on other people (you moms know what I am talking about).

I remember the day of my surgery as if it were yesterday. Dr. Pousti arrived and I was exhausted from getting things done the night before. With his calm and delicate demeanor, he wanted to assure his markings from the previous night and make sure they were "right on" and he said to me, "We're on our way to a homerun" (I could relate as I love sports). I lay back down and his assistant, Michelle, came to walk me to the operation room (by the way, the whole Alvarado team is absolutely FABULOUS too). I walked in the surgery room and Dr. Pousti was all ready and focused with a blanket wrapped around his shoulders. He and his staff guided me to lie down on the table and I remember music playing, that of Elton John. It was a real soothing effect (I thought this only happened in the movies). As Dr. Pousti held my hand, the anesthesiologist said, "Here comes your cocktail" and I believe I said, "Make it a double apple martini", or else I really wanted one at that moment in time. The last words I said to Dr. Pousti is, "You look double" and I was out for the count!

Following, I awoke to a wonderful kind and loving lady named Julie. She is the owner of a Recovery Retreat home called The Hide Away in La Mesa, California. She assured me everything went very well and I knew she was the one to transport me to her center (my aunt and husband also were there). I don't remember much except waking up in a beautiful serene room lit with scented candles, beautiful décor and a nurse that was so sweet and there for my every need. Staying at The Hide Away was of course wonderful for me, but it truly took the pressure off my family for the first and most difficult 24 hour recuperation period (brochures are available at Dr. Pousti's office). I went home a little over 24 hours later, but if money had not been an issue, I would have stayed at least three more days.

I am only 3 weeks out of surgery and love what I see and results are just going to get better as the swelling continues to diminish. My kids ask me, "Can you play with your tummy anymore" (I used to take the extra skin and pull on it and make light of it), but I tell them, I can't do that anymore. I look forward to wearing my clothes the way they should fit, wearing a bathing suit and most of all just feeling more like a 'real' woman again.

Lastly, I always received comments like, "You don't need it, you look wonderful just the way you are", and "You should be proud of the way you look for having 4 children". To these comments, I say, I am proud of who I am and what I look like, but no one understands until they are in your shoes, looking at a body, naked, and feel the emotions you do about what you look like. The point is, do it for you! Yes your husband or significant other will reap some benefits, but you have to do it for you and your self-esteem, at least that is why I did.

You are with the best and as my husband would put it, "If it's not the best, my wife won't go for it". And that I did

Dr. Pousti - Thank you from my heart and soul for all you are!

A very happy patient,

M.O.~ La Mesa, CA

 

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