10554 N. Port Washington Road Mequon, WI 53092 ​

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"When the inner self remains young and strong as the outer surface begins to age, that disparity leads some to seek correction, we as plastic surgeons seek to close the discrepancy between surface and soul."    


                                        -N. John Yousif, M.D​


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10554 North Port Washington - Mequon, WI 53092 | Contact Us

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Dr. John Yousif  ●  SIÈR Medi-Spa ● 10554 N. Port Washington Road Mequon, WI 53092 ​●                          ​● 262.241.SSPA​

W H E R E   S C I E N C E   M E E T S   S O P H I S T I C A T I O N


Patient was 7 years post right Breast Mastectomy  and right Breast reconstruction was done by a different surgeon and the Implant was out of position .

Dr.  Yousif revised the Reconstruction by simple repositioning of implant. 

Natural Looking Designed To You.Although each person's results will differ, before and after photos are good examples of potential changes. They should be used not only as a comparison of techniques and surgeons, but are good starting points for evaluation, comparison and discussion with your surgeon. Please note that these are post surgical photos that are not suitable for all audiences. Viewers should be 18 or older to view the gallery images.




Partial Masactomy with Radiation on left side. Removal of tissue and radiation caused significant irregularity and scaring of left breast.  Reconstruction required a Latissimus muscle  flap from the patient's back along with an implant.   ( the left shoulder scar is from unrelated shoulder surgery) 


Left sided Mastectomy with expander Implant & Reconstruction Right sided Breast

Augmentation for symmetry.


Right side Mastectomy reconstructed with a tissue expander and final implant.  The left breast had a breast lift with an inmplant for symmetry.

Poland's Syndrome

Poland's Syndrome is a congenital malformation of the breast where one breast may be underdeveloped and even the underlying pectoral muscle maybe underdeveloped or missing. 


​This 18 year old patient had Poland's Syndrome.   The patient had reconstruction with endoscopic harvesting of back latissimus muscle with placement of  implant to both breasts.  

Breast reconstruction after a mastectomy with prosthetics or implants is one of two main categories of breast reconstruction. The other method of breast reconstruction is the use of the individual’s own tissue to form the breast.

Prosthetic Reconstruction: There are various methods to form the breast using prosthetics.  The simple placement of an implant in the previous place of the breast tissue that was removed seems simple but does not work.  The skin that remains is too thin and the implant becomes too visible.  To correct that problem, the implant is usually placed beneath the chest muscle (the pectoralis muscle). 

Tissue Expanders: At the end of a skin sparing mastectomy there is a large pocket where the breast tissue was and at the base of that pocket is the pectoralis muscle.  To place an implant beneath that muscle, the muscle must be lifted and stretched to meet the overlying skin. To streched the muscle a tissue expander is placed that will allow slow stretching over a period of time after surgery.  That expansion usually starts at 3 weeks after surgery and continues until the desired volume is achieved. That may take 1-3 months depending on the volume that was placed at the time of surgery, the volume placed at each time and the desired end point.  The expander is then left in place for 3-4 months before the permanent implant is placed.

Direct to Implant Reconstruction:  There is a method of reconstruction that  enlarges the pocket beneath the muscle so that the final implant can be placed at the time of the original mastectomy.  To do that the pectoralis muscle is cut at the lower part of the breast pocket and some form of collagen is placed to make that pocket larger and cover the lower part of the implant which is not covered by muscle.  Denatured collagen is most often from human donated skin that has been treated and the cells have been removed so that there is no cellular rejection.  To do this direct to implant method, the overlying breast skin after the mastectomy must have good circulation because the pressure from the larger implant may further compromise that circulation.   The advantage of this form of reconstruction is that there is no need for a second operation.  The disadvantage is that the second operation to remove the expander and place the permanent implant allows the surgeon to revise and shape the breast.  The may allow for a better final aesthetic outcome.  

Implant above the muscle: There are some recent reports of wraping the implant completely with denatured collagen and placing it above the muscle where the breast tissue was.  These are early reports and long term evaluation is still not there.  

BRAVA and Fat Reconstruction: Some surgeon are simply using fat harvested by liposuction and injecting it to reconstruct the breast.  In most instance a machine called BRAVA is used to stretch the skin from the outside.  It is essentially a large suctio cup that is placed over the breast for a period of time and then fact is injected beneath the skin to create the breast form.  This usually needs to be done 3-4 times to get enough volume of fat to survive and take the form of the breast.  


Bilateral Mastectomy with Expander and Implant & Reconstruction

Click to enlarge the photos


Bilateral Mastectomy with expander | Implant & Reconstruction



Bilateral Mastectomy with Tissue Expander and Finale  Implant & Reconstruction

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 10554 N. Port Washington Road Mequon, WI 53092 ​

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