Breast Implant Reconstruction Surgery
Before and After Photos, FAQ & Information

Symmastia - Bottoming Out - Tuberous Breasts - Lateral Displacement

Breast Reconstruction Options - Breast Recontruction Resources

Breast Augmentation ~ Pocket Correction  

Implant mal-position occurs when the implant is in an incorrect position on the chest wall. This may include incorrect position of the implant superiorly (“riding high”), inferiorly (“bottoming out”), medially (“symmastia or uni-boob”) or laterally (falling outward into the axilla).

Breast Redo after Bottoming Out

Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts.  Also, the distance from the areola to the inframammary fold is too great. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary fold.

      This 25 year old patient from Palm Desert, California had her first breast augmentation surgery performed in Mexico. A few months after getting her breast implants, she noticed that she had developed symmastia (the implants were touching down the mid-line) and her implants were bottoming out. She had a uni-boob (as some call it). The patient was extremely upset about the results and worried about having revisionary surgery. She found Dr. Pousti through her sister who had surgery and was very pleased with her results. She had bottoming out of both breast implants, encapsulation of both sides (left > right), and the areola were displaced laterally on both sides. This patient is ONLY 3 months out of surgery so there is still some bruising and swelling but we can see what an amazing result she achieved. This patient chose to have silicone gel implants (575cc on the left and 533cc on the right). She is VERY HAPPY with her results. 

      This 22 year old patient was not happy with the shape of her breasts after her first breast augmentation.  The implants had bottomed out. She traveled from Boston, Massachusetts to have Dr. Pousti take care of her breast augmentation revision. She is very happy with her results. She has a 390cc saline implant on the left and a 370cc saline implant on the right.

      This 23-year-old patient from Corona California had her first breast augmentation in 2005. She noticed her breast implants "bottoming out" and came to meet Dr. Pousti regarding corrective surgery of her breast implants in 2007. Dr. Pousti performed revisionary surgery with removal and replacement of both breast implants in May of 2007 with 390cc saline implants. Dr. Pousti fixed the position of the pocket so that the breast implants have a natural look to them.  She is 1-month post op revisionary breast augmentation surgery and she loves her results. 

More Bottoming-Out Photos

Repair of Bottoming Out - by Dr. Michael Ciaravino, Houston & Sugarland, TX

Bottoming-Out Photos - by Dr. Frederic H. Corbin, Beverly Hills, CA

Bottoming-Out Photos - by Dr. Thomas M. DeWire, Richmond, VA

Bottoming-Out Photos - by Dr. Don Revis, Fort Lauderdale, FL

Bottoming-Out Photos - by Dr. Steven Teitelbaum, Santa Monica, CA

Bottoming-Out

Bottoming-Out FAQ - by Dr. Thomas M. DeWire, Richmond, VA

Bottoming-Out FAQ - by Dr. Don Revis, Fort Lauderdale, FL

Specialists in Bottoming-Out Repair
Other plastic surgeons may be able to correct your implants, please check our surgeon directory here.

California - Florida - Texas - Virginia

California Plastic Surgeons

Bottoming-Out Photos - by Dr. Frederic H. Corbin, Beverly Hills, CA
Bottoming-Out Photos - by Dr. Steven Teitelbaum, Santa Monica, CA

Florida Plastic Surgeon

Bottoming-Out Photos - by Dr. Don Revis, Fort Lauderdale, FL

Bottoming-Out FAQ - by Dr. Don Revis, Fort Lauderdale, FL

Texas Plastic Surgeon

Repair of Bottoming Out - by Dr. Michael Ciaravino, Houston & Sugarland, TX

Virginia Plastic Surgeon

Bottoming-Out Photos - by Dr. Thomas M. DeWire, Richmond, VA

Bottoming-Out FAQ - by Dr. Thomas M. DeWire, Richmond, VA

Tuberous Breasts

Some patients present to our office with a desire to increase the fullness of the inferior pole of the breasts. The distance from the areola to the “new inframammary fold” is increased using gentle dissection.  Use of an implant can help increase the fullness of the lower poles of the breasts. This is done routinely for patients with constricted or tuberous breasts. Tuberous Breasts have a very narrow base and usually a long skin envelope. Sometimes people refer to "Tuberous Breast" shape as the shape similar to "snoopy's nose". In the most severe cases of Tuberous Breast, a breast lift can be done through an incision around the areola, making the breast into a more rounded shape that the patient will be happy with. In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient.

      This is a 18 year old patient from Murrietta California, interested in breast enlargement and found Temecula Plastic Surgeon Dr. Pousti over the internet. She was looking for a very large result. She also had some constriction of her breasts and wanted the shape to be more natural.  This patient is now 2 months post op breast augmentation with 800cc smooth round moderate profile saline implants made by the Inamed Corporation. She is very happy with her results.

      This 24 year old patient from San Diego, California came in to meet with Dr. Pousti regarding her constricted breasts. She has tuberous (tubular) breasts deformity and wanted breast implants to correct it.  She is now about 2 months post-op correction of her tuberous breasts with 450 cc silicone gel implants made by the Mentor Corporation.  
 

      Lateral Displacement Reconstruction

Some post operative breast augmentation patients present with lateral (outwardly) displacement of the breast implants.  This can be corrected using an internal suture technique decreasing the size of the pockets and moving the implants toward the midline. 

 This 30 year old patient traveled from Arizona to have Dr. Pousti correct her “bottoming out” and the “lateral displacement” of her implants (left >right). Dr. Pousti performed “markings” on the patient the night prior to surgery to assist during the operation the next day.  

In the operating room, you can see how the right side has been corrected and the left has not yet been corrected.  

The patient is only a couple of weeks post-operative revisionary breast surgery but very happy with her results. 

Breast Reconstruction Surgery: Weighing the Options

In an era - medical breakthroughs, it is reassuring to learn that breast cancers are being diagnosed in there earliest stages so that, according to the American Cancer Society (ACS), 96 percent - women with such cancers are alive after five years. Another promising trend: advances in reconstructive techniques have made it possible for plastic surgeons to create a breast that more resembles a natural one.

"One - the most frequent questions among women facing breast surgery is 'how will I look afterwards'?" said Dr. Frank J. Ferraro, an attending plastic surgeon at Pascack Valley Hospital in Westwood. "They worry about whether their clothes will fit and if they will still feel attractive."

In the past, the majority - women who had mastectomy surgery wore a prosthesis - a breast form made from materials that have the weight and feel - a natural breast - in their bras and bathing suits after surgery. Many women found such a prosthesis inconvenient or uncomfortable and wanted to feel "whole" again; plastic/reconstructive surgeons began to develop techniques to restore the shape and contour - the original breast. According to NIH, today about 75 percent - women who have mastectomies choose postsurgical reconstruction.

CHOICES IN BREAST RECONSTRUCTION

If you are planning to have breast reconstruction surgery, you must find a plastic surgeon skilled in the procedure before the mastectomy surgery so that the plastic surgeon can work with the general surgeon to develop a plan that lends itself to reconstruction. Since this is a demanding technique, it is important to choose a plastic surgeon who is bored certified in this specialty and experienced in breast reconstruction.

Women can choose to have the procedure at the same time as the mastectomy operation or return to the hospital for reconstruction several weeks or months later. The women and her surgeons will discuss what type - procedure is best for her: an artificial implant or a muscle-flap procedure in which the breast is reconstructed with skin, muscle and fat taken from another part - her body. Factors to be considered include the woman's medical history, height, weight and amount - body fat as well as other medical conditions.

CHOOSING A MUSCLE FLAP

The TRAM flap is another variation. The flap comes from the transverse rectus abdominus just below the waistline. The reconstructive surgeon detaches a small piece - skin, muscle and fat and pulls it through a tunnel under the skin between the abdomen and chest. Some women have enough extra fat in the abdomen to create a breast shape without an implant.

One advantage - the TRAM techniques is that some women find that their abdomens look flatter - as though they have had a tummy tuck. Women who have chronic lower back problems often choose other techniques since they may develop weakened abdominal muscle after the procedure and can increase back strain.

 A third technique, the free flap, eliminates the tunneling step. A portion - skin, fat and blood vessels is removed from the buttock, thigh or abdomen and move to the breast area. The blood vessels in the flap are sewed to the vessels under the arm at the mastectomy site. Because extensive microsurgery is required to reattach the blood vessels, the free flap is the most technically demanding - the muscle flap procedures. This technique, however, gives superb results.

"Women who smoke or have diabetes may be poor candidates for muscle flap procedures because their blood vessels may have narrowed enough to prevent healing - the flap," Dr. Ferraro noted. "That's why we advise patients to quit smoking and keep their blood sugar as close to normal as possible so that they can benefit from these procedures and have a natural looking breast."

Breast Reconstruction Surgery Before & After Photos

California - Florida - Illinois - Indiana
Maryland - Nevada - New Jersey - New York
Ohio - Pennsylvania - South Carolina
Texas - Virginia - Wisconsin

California Plastic Surgeons Breast Reconstruction Before & After Photos

Implant Exchange Photos ~ Dr. Calvert, Beverly Hills & Newport Beach, California
Breast Reconstruction Photos ~ Dr. Calvert, Beverly Hills & Newport Beach, California
Breast Reconstruction Photos ~ McNemar Cosmetic Surgery, San Ramon & Tracy, CA
Dr. Pousti's Breast Reconstruction Photos - San Diego, CA
Dr. Corbin's Breast Reconstruction Photos - Beverly Hills, CA

Florida Plastic Surgeons Breast Reconstruction Photo Gallery & FAQ

Dr. Leonard Hochstein Breast Revision Photos - Miami ~ Aventura, Florida

Dr. Edison's Breast Reconstruction Photos - Hollywood & Miami, Florida

Dr. Man's Breast Reconsturction Photos - Boca Raton, Florida

Dr. Simon's Breast Reconstruction Photos - Fort Lauderdale, Florida

Dr. Hasen's Breast Reconstruction Photos - Naples, Florida

Maryland Plastic Surgeons Breast Reconstruction Photo Gallery

Dr. Cohen's Breast Reconstruction Photos - Westminister, Maryland

Nevada Plastic Surgeons Breast Reconstruction Photo Gallery

Breast Implant Reconstruction Photos - Bongiovi Center for Plastic Surgery ~ Las Vegas, Nevada

New Jersey Plastic Surgeons Breast Reconstruction Photo Gallery

Dr. Fiorillo's Breast Reconstruction Photos - Pearl River, NY & Westwood, NJ

Dr. Friedlander's Breast Reconstruction Photos - Short Hills, NJ

New York Plastic Surgeons Breast Reconstruction Photo Gallery

Dr. Fiorillo's Breast Reconstruction Photos - Pearl River, NY & Westwood, NJ

The Plastic Surgery Groups' Photos - Albany, NY

Breast Reconstruction Photos Dr. Freund - Manhattan & Long Island, NY

Dr. Berger's Breast Reconstruction Photos - New York, NY

Pennsylvania Plastic Surgeons' Breast Reconstruction Photo Gallery

Dr. Silberman's Breast Reconstruction Photos - Doylestown, PA

South Carolina Plastic Surgeons' Breast Reconstruction Photo Gallery

Dr. Lettieri's Breast Reconstruction Photos - Spartanburg, SC

Texas Plastic Surgeons' Breast Reconstruction Photo Gallery

Breast Asymmetry Correction - Dr. Byrd, Dallas, Texas
Dr. Kunkel's Breast Reconstruction Photos - Fort Worth, Texas
Dr. Pilcher's Breast Reconstruction Photos - San Antonio, Texas

Virginia Plastic Surgeons' Breast Reconstruction Photo Gallery

Dr. Brown's Breast Reconstruction Photos - Herndon, Virginia

Midwest Plastic Surgeons Breast Reconstruction Before & After Photos

Dr. Fedele's Breast Reconstruction Photos - Willough Hills, Ohio

Genesis Cosmetic Surgery Center and Medical Spa's Photos - St. Louis, MO

Dr. Gerson's Breast Reconstruction Photos - Lake Geneva, Wisconsin

Dr. Short's Breast Reconstruction Photos - Indianapolis, Indiana

Breast Reconstruction Photos - Dr. Rios, Plastic Surgery & Dermatologic Institute, Chicago, IL

Breast Reconstruction Surgery Resources

Breast Reconstruction Information - Dr. Robert Goldstein & Dr. Heather Erhard, Bronx & Manhattan, NY

Breast Reconstruction Information - Dr. David Kim, Beverly Hills, CA

Breast Reconstruction Information - Dr. Joshua Korman, Mountain View, CA

Free-Flap Breast Reconstruction Information - Dr. Joshua Korman, Mountain View, CA

TRAM Flap Breast Reconstruction Information - Dr. Joshua Korman, Mountain View, CA

Breast Reconstruction - Dr. Kelly R. Kunkel, Fort Worth, TX

Breast Reconstruction - Dr. John T. Lettieri, Spartanburg, SC

Breast Reconstruction - Dr. Daniel Man, Boca Raton, FL

Breast Reconstruction - Dr. Constantino G. Mendieta, Coconut Grove, FL

Breast Reconstruction - Dr. Sheryl G. Pilcher, San Antonio, TX

Postmastectomy Breast Reconstruction - Dr. Otto J. Placik, Arlington Heights, IL

Breast Reconstruction - Dr. Tom Pousti, San Diego, CA

Breast Reconstruction - Dr. Mary A. Powers, Long Beach, CA

Breast Reconstruction Information - Dr. Robert Rothfield, Weston, FL

Breast Reconstruction - Dr. Kimberly K. Short, Indianapolis, IN

Breast Reconstruction Information - Dr. David Silberman, Doylestown, PA

Breast Reconstruction - Dr. Peter J. Simon, Fort Lauderdale, FL

Breast Reconstruction - Dr. Kenrick A. Spence, Orlando, FL

Breast Reconstruction - The Plastic Surgery Group, Albany, NY

Breast Reconstruction Information - Turkle & Associates, Carmel, IN

Breast Reconstruction Information - Dr. Jennifer Walden, New York, NY

Breast Reconstruction Information - Dr. Steven Wallach, New York, NY

Breast Reconstruction Information - Dr. Laurence Weider, Dallas, TX

Breast Reconstruction Information - DR. Scott Zevon, New York, NY

Breast Reconstruction Information - Dr. John B. Harris, Ponte Vedra Beach, FL

Breast Reconstruction Information - Dr. Robert M. Freund, Manhattan & Long Island, NY

Breast Reconstruction Information - Dr. Brian Howard, Roswell & Cumming, GA

Post-Mastectomy Reconstruction Information - Dr. Kent Hasen, Naples, FL

Breast Reconstruction Information - Dr. David L. Abramson, New York, NY & Englewood, NJ

Breast Reconstruction Information - Dr. Mariam Awada, Southfield, MI

Breast Reconstruction - Dr. Gary S. Berger, New York, NY

Breast Reconstruction - Dr. Michael J. Brown, Herndon, VA

Breast Reconstruction - Dr. Frederic Corbin, Beverly Hills, CA

Breast Reconstruction Information - Dr. Richard Edison, Hollywood & Miami, FL

Breast Reconstruction Information - Dr. Beverly Friedlander, Short Hills, NJ

Breast Reconstruction Information - Genesis Cosmetic Surgery Center and Medical Spa, St. Louis, MO

Breast Reconstruction Using Tissue Expander Implant - Dr. Gregory M. Fedele, Willough Hills, OH

Breast Reconstruction - Latissimus Dorsi Flap - Dr. Gregory M. Fedele, Willough Hills, OH

Breast Reconstruction - TRAM Flap - Dr. Gregory M. Fedele, Willough Hills, OH

Breast Reconstruction Information - Dr. Michael Fiorillo, Pearl River, NY & Westwood, NJ

Breast Reconstruction - Dr. Gregory Fedele, Willough Hills, OH

Breast Reconstruction - Dr. Frank J. Ferraro, Ridgewood, NJ

Breast Reconstruction - Dr. Robert M. Gerson, Lake Geneva, WI

Breast Reconstruction - Dr. Scot B. Glasberg, New York, NY