Do I Have The Waterfall Effect? (photo)

I had BA and BL march 2011. From day 1 I could tell my breast werent going to look like I wanted them too. No matter if im laying down standing up sitting up my implants remain under my armpits giving me major side boob and leaving me with no fullness and flat chest. When i lay down my skins falls to the side also and leaves me a huge gap and saggy skin where my implant should be. my nipples are flat and it looks like my breast tissue is falling off my implant. I have 480cc in both under muslce.

Doctor Answers 7

Concerns after Breast Augmentation/Lifting Surgery?

Thank you for the question and pictures.

Based on your pictures and description,  I think you're dealing with a lateral breast implant displacement problem. Your breast implants move off to the side, especially when you lie down. Correction would involve an internal suture repair of the breast implant pocket ( capsulorraphy), decreasing the size of the pockets and moving the implants toward the midline.   In my practice, this repair is done with a 2 layered permanent suture technique. The use of acellular dermal matrix is an option ( although not usually necessary)  especially if significant implant rippling/palpability is present.

If “saggy” skin is also an issue, revisionary mastopexy surgery may also be indicated.

 I would suggest that you express your questions/concerns with your plastic surgeon in a calm and constructive fashion.

Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Problems after Lift/Aug

After reviewing your images it appears that you have two issues. First, your implants are becoming displaced towards your armpit when you are upright and laying on you back. This is caused by the size of the pocket with it being to large towards the armpit and gravity pulling the implant in that direction. The remedy is to make the pocket more narrow and it does require more surgery with internal sutures. Second, on the side view the breast tissue is sagging still and you would benefit from more tightening of the skin to correct this issue. I would revisit this with your surgeon and see what they have to say.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.5 out of 5 stars 18 reviews

Do I Have The Waterfall Effect?

Sorry for your issues but the posted photos are of little aid. Best to see second opinions in person. But you seem to have lateral implant displacement. Only further surgery can correct. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Displacement of breast implant

I agree with you that your implant has shifted out of position. This is usually due to over dissection creating too large a space for the implant. Sometimes it can also be due to too much use of the arms in the early post op period, if the implant is put beneath the muscle. As the muscle is tightened it can push the implant down and outward. Return to your surgeon to discuss treatment options. It is usually not hard to fix.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Lateral breast displacement

Just based solely on the photos and your description, it sounds like your implants are falling off to the sides. You may need a revision.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Revision breast augmentation should give you perkier shape.


Hard to be sure from pictures, but it looks like the implant pockets are too large and the implants do not stay under the nipples.  This should be correctable.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

You Need major revision of the lift and implant

We do not have your before pictures and after pictures shows the things that you mentioned. You still have a lot of loose skin and need to have revision. The implant pocket need to be revised. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.