3 years post revision surgery - Is this waterfall deformity and how involved is it to fix? (Photos)

Question

I believe I have a waterfall deformity in my left breast. I am a 52 year old woman. I had breast revision surgery 3 years ago switching from 375 cc submuscular saline implants to 400 cc submuscular silicone implants. The left implant has always been higher, looking more pushed up than the right. I feel like it just needs to be lowered and that would correct it. I am wanting to know if this is the case or is it more involved than I am believing.

Harry T. Haramis, MD, FACS · Answer

All breasts are different left to right before and after any surgery. They can also heal differently.

The higher side likely has some capsule or scar tissue which can distort that side.

Removing the scar tissue usually benefits from changing the implant and adding mesh to decrease recurrence along with lowering the implant pocket for better symmetry.

This will alleviate the water fall deformation.

This would be confirmed and discussed during consultation with a plastic surgeon.

Ned Snyder, IV, MD · Answer

Thank you for submitting your questions/photos.  I’m sorry you are experiencing some breast asymmetry after your augmentation.  Based on your photos, you have several options.  You can revise the left breast by opening the capsule around the implant and letting that implant sit lower in the breast pocket.  There’s a chance this could return with time.  Another options would be to move your implants from beneath the muscle to on top of the muscle and support them using a small piece of dissolvable mesh.  This would reduce the risk of the implant creeping back up on the chest wall.  I highly recommend you seek out a consultation with a board certified plastic surgeon to review all of your options.  Good luck and thanks again for reaching out!

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  You definitely have a waterfall deformity.  I have been in practice for over 30 years, and revisionary breast surgery is a large portion of my practice.  In your case, I would suture the pockets-internal bra to bring the implants closer together and perform a mastopexy-lift.  You should be able to have a beautiful result.  Best wishes to you.

Gary M. Horndeski, MD · Answer

Your breasts have fallen inferiorly and laterally. At this time, I recommend explantation and breast lift using the Bellesoma. 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

3 years post revision surgery - Is this waterfall deformity and how involved is it to fix? (Photos)

Answers (4)

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