Can waterfall effect be corrected with smaller implants and no lift? (photos)

Dear Tammyof4,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Waterfall ptosis is where the breast tissue sags but implants stay up. Most of the time it is best to do a lift, depending on the location of the nipple relative to the bottom edge (inframammary fold) of the breast. Smaller implants may end up with a "rock in a sock" look. However, your surgeon is in the best position to advise you.

You need a lift. However, placing the implants on top of the muscle should avoid the waterfall fall look since the implants can sag with the breasts.