San Diego Cosmetic Surgeon Dr. Tom Pousti Talks About Transgender Procedures

Welcome Transgender Patients!

Dr. Pousti and his entire office staff are sensitive and highly experienced in the special needs of transgender patients. The procedures involved with transgender procedures may include breast augmentation, laser hair removal, CO2 laser skin resurfacing, laser tattoo removal and more. Dr. Pousti would be happy to learn more about your personal goals and desires to help evaluate which options would work best for you.

Note Prime Plastic Surgery does NOT require psychological evaluations (in most cases). In most cases we perform transgender procedures by informed consent, which means our patients give us permission to treat granted in the knowledge of all possible consequences, risks and benefits.

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Surgical Options to Consider

There are a number of options to consider when planning the breast augmentation component of your transgender surgery including:

  • Saline vs. Silicone Implants
  • Round vs. Teardrop Implant Style
  • Smooth vs. Textured
  • Profile Type (High, Moderate or Low)
  • Location of Incision (Submammary, Infra-Areolar, Axiliary, or Peri)
  • Implant Size
  • …and Other Considerations

Dr. Pousti offers a wealth of experience in working directly with the transgender community and listening to each patient’s specific and unique needs and desires to help ensure absolute success in the surgical results. To read more how Dr. Pousti works in listening to the specific needs of each patient with the use of visual aids to ensure proper expectations are met with each patient, click the button below.

What To Expect After Surgery

The expectations after surgery depend on what surgery is performed. Normally, after a procedure in which a patient is put under general anesthesia, there is recovery time. Pain and/or nausea may be associated with certain procedures (which you will be given medication for). After certain procedures, there is minimal pain and/or recovery time.

Resumption of Physical Activity

Again, depending on what procedures are performed, the recovery time will vary.

Patient Before Breast Augmentation

Transgender Patient’s Prosthetic Breast Inserts

Patient After Breast Augmentation


I have NEVER met a finer,kinder,more professional,generous and wonderful human being that that of Susie Singleton. My management of pain and getting propped up in bed and sitting was so wonderfully handled and supported by Susie. I have never had a better experience and more fun enduring difficult circumstances. None of what I say is an overstatement in any way.


In August of 2012, I started to research breast augmentation surgery. At the time I felt really tired of using various methods to “enhance” my chest. Padding and stuffing made me feel horrible and fake. After getting fed up with these feeling I made the decision to get breast implants.

I found Dr. Tom Pousti through after searching for transgender breast augmentation on the site. He had many favorable reviews and before and after pictures. Dr. Pousti’s personal website also had a wealth of information that I found useful including information on transgender breast augmentation. He was the only doctor I could find that had examples of his previous surgeries on trans patients. As a transwoman I found it comforting that he had experience working with transgender patients.

In January of 2013, I had my consultation with Dr. Pousti The staff was pleasant and courteous. At the time I still had a legally male name, however the staff had no problems using my female chosen name. During the consultation I was shown a lot of different examples of the doctor’s previous surgeries. The doctor also introduced me to three of his former breast augmentation patents. I found talking to these patents most helpful. It gave me a better idea of what to expect out of this surgery. In addition, the doctor spent a considerable amount of time talking to me about what he thought he would be able to accomplish with the surgery and answered any questions I had. All in all it was a pleasant and informative consultation. Dr. Pousti’s enthusiasm, experience, intelligence, and genuine concern for his patents convinced me that he was the best choice for doing my surgery.

On June 3 I went in for my pre-op. I was traveling from Northern California so my pre-op appointment was the day before my surgery. A number of days before this appointment I started to get a little worried about the surgery. This was my first surgery so I didn’t know what to expect going into the operating room. All I could think about was the complications that could happen. Dr. Pousti talked to me about my concerns and put my mind at ease.

The surgery went extremely well. Before the surgery I didn’t really know the size of the implant the doctor was going to use. He asked in the pre-op if would be more disappointed with having the breasts too big or too small. I told him that I would obliviously be more disappointed with my breasts being too small. He was able to work his magic and somehow fit 650cc implants in my body. It felt great looking down at them after the surgery.

For the next few days after the surgery I was recovering in my hotel room waiting for my follow up appointment later that week. During this time I was having my mother taking care of me. I couldn’t really use my arms so she had to help me with a lot of thing including getting in and out of bed. The pain on the second day after the surgery was the day I started to feel a lot of pain. It wasn’t too bad but, it made it really hard for me to be comfortable. The doctor’s office called me every day for the first week and a half to answer any questions and to see how I was doing. They were very helpful in providing me with ways to make my recovery more comfortable.

So far I have been extremely happy with the results of the surgery. The breasts Dr. P has given me, feel like the breasts I should have developed on my own. They feel like they have always been there. They just feel right. Dr. Pousti and his staff are professional and look out for the best interest of their patients. I would highly recommend Dr. Pousti for anyone thinking about having breast augmentation.


Being transgender, with no breasts, I love boobs and missed having them. I decided to rectify this situation. I have girlfriends of varying breast size who have had “boob jobs”, so I was somewhat aware of what was achievable, If I was to make any impression on my chest, then I needed a specialist surgeon. I did the “net search”, enquired locally as well as the obligatory “Thai Hospital”. I ended up time and time again with my search for XL breast augmentation the same Southern Californian surgeon.

Having decided to have a breast augmentation I also decided to go big as I had been wearing my EE false silicone prosthesis. I wore these for a year 24/7 right up to the operation so that I could as best as I cold be sure I was making the right decision. I am now 1 month post op, I have never had any doubts about my decision or the surgeon I chose.

My scaring from the incisions barely visible, it is about 1” long on each breast around he lower edge of the aloa. The stitches were so so fine, I am so impressed.

When considering my recovery, I have been very fast, on the better end of the advice I was given or better. I put this down to, yes a great surgical team, but when the surgery finishes, you have to do the rest. I have followed the postoperative advice to the letter.

I am 63 Kg, 1.8m/ 5’11”. Through pilaties every day I have good core strength. This all helped me carefully moving post operation, so much that it was noted by the nurse I had to care for me for the first 24 hours from discharge. I have a very good diet and take particularly good care of myself.

I look upon my surgery as life enhancing and I am so glad I did it. It is my intention to do it all again in a year or 2 to get me to the breast size I have always wanted. My skin can only stretch so far in one go, it is indeed stretching further that I had thought possible and twice as much as surgeons locally to me in Australia had suggested they could manage. I have 400 cc of Saline each side.

Next time I will do the same again, same surgeon and ask the same of him, to make them as large as he can safely. I trusted him last time and I have every reason to do so again.


Thank you Dr. Pousti for the wonderful 3 month followup visit with you and your extraordinary support staff today! You all made me feel like extended special family! The girls are absolutely beautiful and amazingly there is no scar visible. You are a true artist, a truly gifted surgeon and an extra special human being!

Transgender Patient At Her Pageant Competition

Prime Plastic Surgery consists of the top board-certified surgeons in the country providing the highest caliber of patient care. We offer cosmetic and reconstructive procedures, both surgical and non-surgical, to help patients achieve truly life-changing results. Our surgeons are members of several prestigious organizations, including:

  • American Society of Plastic Surgeons
  • American Society for Aesthetic Plastic Surgery
  • International Society of Aesthetic Plastic Surgery
  • American Association for Accreditation of Ambulatory Surgery Facilities

Discover what the Prime difference can do for you. Request a consultation online or call our practice at (858) 285-4667.

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