Is a lift revision alone what is recommended to fix my waterfall deformity without lowering the implants? (photo)

Your breast tissue is low and the implants are high. You choices are switch to smaller implants or lower the pocket of the high implants. Lifting the nipple-areola complex will not be effective. The anchor lift is notorious for not lifting breast tissue but just the areola. Another alternative is removing the implants and using fat transfers with smaller implants.

Best Wishes,

Gary Horndeski, M.D.

From the photo it appears one implant is seated too high still. Your surgeon can help it drop into the correct position via a surgical procedure. Further photos are needed to determine if a revision to your lift is recommended.

Just based on your one photo, one implant is sitting too high. It might possibly lower with oral Accolate and external ultrasound treatments, or may need surgery to open the capsule.