Waterfall breasts after over-to-under muscle implant revision for sagging, don't know what to do? (Photos)

Question

I got a breast lift with implants over the muscle high profile 400 cc on each side within 6 months they completely sagged. My doctor agreed to fix them for a second time we went under the muscle this time and kept the same implant remove more breast tissue but now I have developed a waterfall breast look and animation deformity. My doctor has once again agreed too fix the issue he wants to drop the implant because it’s sitting to high and take out more tissue, but I don’t know what to do

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. A large portion of my practice is dedicated to breast revision. I often perform excision of inferior pole breast tissue during mastopexy-breast lift. Over the years, I have developed a technique known as " reductive augmentation ". You might be an excellent candidate for this.  In your case, I would not lower your implants, but redo the left with excision of the inferior pole, redundant breast tissue.  Best wishes to you

Gary M. Horndeski, MD · Answer

The problem you are having is your implants are at one level and your breast tissue is at another. The vertical scar lift technique was inadequate to lift your breasts. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Magical415104,
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

Connie Hiers, MD, FACS · Answer

You may need an internal mesh bra to help support your sagging tissue. I would keep the implants behind the muscle for better coverage and upper breast fullness and support to the implants.  Some lower sagging tissue could be trimmed as well.

Waterfall breasts after over-to-under muscle implant revision for sagging, don't know what to do? (Photos)

Answers (4)

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