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Tom J. Pousti, M.D.

    Answered Questions

    Q:

    Am I able to have breast augmentation surgery without the risk of developing a second blood clot?

    I am 27 years old and had a blood clot in 2009.  The doctors could not find out what caused the clot.  I want to get breast augmentation.  Can I, and will I be at risk for developing another clot?

    A:

    Yes, you can have a breast augmentation after workup by a Hematologist to determine any underlying "disorder" that may be increasing your risks for developing a repeat blood clot.  The Hematologist may also have recommendations for medications around the time of your surgery.  Fortunately, the breast augmentation procedure, is a relatively short procedure- many patients with your history have had successful breast augmentations without complications. Best Wishes.

    Breast Augmentation

    Q:

    Is it normal to have pain twinges and a burning sensation in the abdomen two weeks after having a tummy tuck?

    I had a tummy tuck on 8/23.  I notice when I cough or sneeze, I have pain twinges and a burning sensation in the abdomen.  It almost feels like my internal stitches have given away.  Is this a normal feeling during the healing period?

    A:

    Most likely, what you are experiencing at 2 weeks post operatively is normal.  If you have any other physical findings such as unusual "bulge" or fluid wave sensation you should see your plastic surgeon for evaluation as soon as possible. Otherwise keep in close communication with him/her.

    Best Wishes.

    Tummy Tuck

    Q:

    In breast augmentation surgery is it safe to go from submuscular to subglandular and back to submuscular again?

    I had several breast augmentations, all submuscular (160cc then 190cc) starting in 1995.  Revisions were done due to bad placement and capsular contracture.  To correct the last problem the surgeon placed new implants subglandular 15 months ago.  It fixed the problem but because of very little tissue I have rippling and the implants are very low.  I would like to go down from 255cc (the doctor's choice) to 210 or 220.  Is it safe to go back to submuscular and how difficult will it be?

    A:

    Yes, it will be "safe" to return to the sub-muscular position.  This will be the most effective way to treat the rippling.  Additional work such as skin excision and/or the use of Allograft may be necessary/beneficial. Pictures or in person examination are really necessary to give you the best advice. 

    I hope this helps.

    Breast Augmentation

    Q:

    Always having large breasts and now at 25 currently wearing a size 42DDD bra, am I a candidate for breast reduction?

    I am 25 years old, and currently wear a size 42DDD bra.  I have had large breasts since I hit puberty and have always been self conscious about the way they look.  I have lost 60 pounds but still feel that my breasts are too large.  I worry about them getting even larger when I become pregnant and then nursing my baby.  Am I a candidate for breast reduction?

    A:

    Breast Reduction is a personal choice and it sounds like you are uncomfortable with your current size.... but if you are asking if you are a good candidate for insurance to cover the breast reduction, each insurance company is different with what they require to "authorize" the breast reduction surgery through insurance.  I write a letter and send photos of the patient when trying to get authorization (I am sure most plastic surgeons do this as well).  Also, getting supporting letters from other doctors who can document that you have had neck, back and shoulder pain and/or rashes due to the large breasts will help. Supporting documentation is usually very helpful.

    Breast Reduction

    Q:

    After getting breast reduction, will I be able to work out comfortably once my breast size is reduced?

    I am looking into getting a breast reduction. I have been a cup size D since I was 14 years old; I am now a size DD at 20 years of age.  I would like to have the reduction surgery mostly for medical reasons.  I am overweight at 180 pounds.  During the past several years, I have tried working out but all of the moving around hurts my breasts, shoulders, back, neck, etc.  Will most insurance plans cover the reduction surgery, or will I have to find a way to lose the weight first?  If I have the surgery and my breasts heal, will I be able to work out more comfortably?

    A:

    Each insurance company is different with what they require to "authorize" the breast reduction surgery through insurance.  I write a letter and send photos of the patient when trying to get authorization (I am sure most plastic surgeons do this as well).  Also, getting supporting letters from other doctors who can document that you have had neck, back and shoulder pain and/or rashes due to the large breasts will help.  Supporting documentation is usually very helpful.

    In regards to being able to exercise after the procedure, that should not be a problem.

    Breast Reduction

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