57, waterfall issue after 11 years, is it time for a revision? (Photos)

Hi @mainemom, I do think you should have your previous surgeon (or a new one if they are unavailable) take a look. I usually see my patients at least annually to see what natural changes are occurring. Most commonly there will be changes to the soft tissues (breast tissue) that occur around the implant, such as the "waterfall deformity" that you mentioned. Separately, the implant can have issue with capsular contracture, or worsening scar tissue that make it tighter, change the shape, or affect the position of the implant behind the breast tissue. One or both of these things could be contributing to the changes you have seen over the last 11 years. The last thing to consider is that if you silicone gel implants and have never had imaging, then you are overdue for either an ultrasound or MRI to see if the implant is still intact or ruptured. This is the FDA recommendation. It's not an emergency if the implant has ruptured, but at least you know it's time for an exchange. Whether you do another lift at the same time would be a cosmetic concern and up to you and your surgeon

Excellent question! There is no one-size-fits-all answer to that question, just like there is no one-size-fits-all implant. The simplest way of answering is to essentially advise that when something bothers you enough that it feels worth having surgery to correct it, that’s when it is time for a revision. Of course, things like a ruptured implant or a capsular contracture could push you to feel its worth having surgery sooner (and it is important to make sure to regularly have your implants checked to make sure there aren’t any actually issues with the implants). A better question for RealSelf would be “can I benefit from a revision” and in this case you definitely can. You do have an early waterfall deformity and the implants both appear to be sitting quite high so seeing an expert in breast revision near you would be advisable to see what specifically needs to be done to improve your results. Based on the photos it appears as though you’d benefit from having your pockets adjusted to let the implants sit in a more natural position and give a softer look and then have the lift revised to bring the breast tissues into harmony with the implants. If a capsular contracture is present that will need to be addressed as well.

Bottom line, if you aren’t bothered by the appearance and you have had your implants assessed to ensure that they are not ruptured then you do not NEED to have a revision, but if the implants are ruptured, uncomfortable or you just want the appearance improved then it certainly would be reasonable to have a revision at this point. Hope that helps!