5 years post op - do I have Waterfall Deformity? (Photos)

Question

So I had my BA 5 years ago, didn’t have much breast tissue to begin with, and I got 300cc B-lite anatomical high projection implants. Do I have waterfall deformity or has the implant been placed just too high (since I didn’t have much tissue to sag)? Even if it is waterfall deformity, should I change them necessarily? Thank you!

Daniel Barrett, MD · Answer

Dear Reliable482181,

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

Brian K. Reedy, MD · Answer

Thanks for your question! It doesn't look like a waterfall deformity to me. My suspicion is that you have always been slightly ptotic because you have a very short/small distance from the bottom of your areola to your inframammary fold. If you are happy with the breasts otherwise but would like your areola more centered, you could consider a breast lift. Good luck!

Wayne I. Yamahata, MD · Answer

It does not appear that you have a waterfall deformity, but your nipples are centered low on the breast mound which compromises the aesthetics. Anatomical issues may limit the ability to modify this. Consult with your surgeons to discuss your options.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Always good to check with your surgeon. If that is not possible then it would be useful to get an in person evaluation by a plastic surgeon. I only change implants if they rupture, deflate, or if a patient wishes to change the size. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Ram Kalus, MD, FACS · Answer

Thank you for your question and photo. An examination in person would be required to properly evaluate your situation, but it appears that your implants are too high in relation to the bottom of your breast.

I would recommend discussing your concerns with your plastic surgeon, or another experienced plastic surgeon who has experience with revision breast augmentation. Best of luck to you.

Jeffrey M. Darrow, MD · Answer

Thank you for your photo. It does appear that you have slightly too much superior pole fullness, and this likely results from the implants being placed slightly high and this results in your nipple being positioned slightly below the midpoint of the implant.  Check with your surgeon, whether it would be possible to move the implants slightly lower and retain your original implants or whether you may need an exchange for new implants to maintain your warranty.  A waterfall deformity typically occurs when somebody has a fair amount of very mobile breast tissue, which initially sits in the correct position in front of the implant, but then over time, due to gravity and aging, the breast tissue settles and hangs off the front of the implant.  Another option for positioning your nipple at the midpoint of the implant is to have a small breast lift, however, this would place new incisions on the front of your breast, and you may wish to avoid this. Best wishes.

Connie Hiers, MD, FACS · Answer

You chose a high projection implant and that is what you have. If you want, you could go down in profile for a little more realistic look. If you are happy, keep what you have.  You do not have a waterfall deformity.

Camille Cash, MD · Answer

From the photo it doesn't appear you have waterfall deformity.  The implants may need to be repositioned a bit for a better result.  See a board certified plastic surgeon near you for an evaluation.

Mauricio Castano, MD · Answer

Hi, a proper physical examination is necessary to determine weather is a waterfall deformity or a high riding implant. If you aren't happy with the shape of your breast, that would be a recommendation to change your implants. 
 A waterfall deformity is fixed with a pocket exchange, or even with an implant in a dual plane with a pexy (depending if ptosis is present) in most cases, but as I mentioned, a proper evaluation is suggested to have a good diagnosis and solution to your case. Hope this works for you.

5 years post op - do I have Waterfall Deformity? (Photos)

Answers (9)

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