Does my right breast have waterfall deformity? (Photos)

Question

Female, 34 years, had my surgery in nov 2024. Does my right breast is showing any waterfall deformity signs ? Thank you

Semih Yildiz, MD, FEBOPRAS · Answer

Waterfall deformity means the breast tissue has dropped off the implant while the implant stays relatively high, often with the nipple/areola sitting low on the breast mound. In your photos, there is some asymmetry and the right lower-pole/areola relationship should be checked, but I would not diagnose a true waterfall deformity from photos alone.
Since your surgery was in November 2024, the result is likely fairly mature. If the shape is stable and you like the overall look, observation may be reasonable. If the right breast tissue is sliding over a higher implant or the nipple position bothers you, correction depends on the cause and may involve pocket adjustment, implant position change, or a small lift/tightening procedure after an in-person exam.

Ira H. Rex III, MD · Answer

Waterfall deformity is a clinical diagnosis made best on exam.  It seems you have significant asymmetry of the nipple position, and this itself could give the impression of a waterfall deformity.  He should check with your plastic surgeon regarding this.  The only reason to approach this surgically is if it bothers you.  See what the options are.

Daniel Barrett, MD · Answer

Dear Cheerful5823,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donovan Rosas, MD · Answer

Waterfall deformity occurs when the native breast falls off the implant mound. Also known as a "snoopy" deformity...a complication in which the breast implant sits higher, and the tissue drops below it, creating a drooping, "sad Snoopy dog" appearance.

Based on your photos, you may have some mild degree of "bottoming out." The NAC appear to be stargazing as the implant is descending and the native fold is rising  (most noted on the R).

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

John LoMonaco, MD, FACS · Answer

I don't see evidence of your breast tissue slipping or "falling" off the implant.  What I do see is a bit of natural shape difference and height difference between your 2 breasts that every woman has to some degree.  An in-person exam is the best way to answer these questions, but from the photos you dont seem to have that issues. Cheers from Texas.

Zoran Potparic, MD · Answer

Based on these photos, your implants are positioned lower and your inframammary fold is lowered; this makes your nipples to sit higher on the breast mount. Lifting inframammary fold (sometimes a very difficult procedure) will correct this deformity, push implants higher and visually lower the position of nipple/areola. I hope this helps.

Shlomo Widder, MD · Answer

Dear Cheerful,
    Thanks for posting your picture. From observing your picture, you appear to have bilateral breast bottoming out - too low submammary creases and too high nipples.  More so on the right side of the picture (your left breast). To solve that problem , you will require surgical   inferior capsulorrhaphy ( internal bra ) bilaterally. This procedure will raise your submammary creases and position your nipples in a more natural level. Most likely you will need also superior capsulotomy ( scar release ) to allow the implants to move upward and create natural upper slope.
    Always consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after photos of redo breasts augmentation in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage. perky, natural upper slope and natural looking.
                  Best of luck,
                                            Dr Widder

Camille Cash, MD · Answer

From the submitted photos it does not appear that you have waterfall deformity.  There is some asymmetry of the nipple position, but it appears it was present immediately after surgery as well.  I encourage you to discuss your concerns with your surgeon.

Brandon Elnekaveh, MD · Answer

Hi! Judging by the photos I don't see the breast "falling off" the implant as in a waterfall deformity. Sometimes lateral photos are useful to see that, and definitely an in person consultation. Is one photo a selfie and the other not? Hard to see which side is which. You do have a natural difference between the two breasts, likely present before surgery. Looking at your preoperative photos can be helpful. Little differences like yours are common. Best of luck.

Does my right breast have waterfall deformity? (Photos)

Answers (9)

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