Why do I have waterfall deformity again after capsulectomy, replacement implants and lift? (Photo)

It appears that you have a recurrence of the capsular contracture. Medications such as montelukast may be of benefit but unfortunately it is likely that you will require further surgery. Schedule a visit with your surgeon for a definitive diagnosis and treatment options.

It appears that you have recurrent capsular contracture. This is not inevitable and I suggest that you procure the surgeon's operative notes for you to review. What you want to see in the note are: 1. inframammary approach to the capsulectomy, which should be the first order of business in the operation. 2. a total or near total capsulectomy. 3. irrigation with antibiotic containing saline solution and Betadine irrigation as well. 4. the use of a sterile funnel to place the implants through the inframammary incision. 5. closing the implant pocket prior to proceeding with the breast lift. 6. if even documented, glove changes when handling the implants. These are the important steps to prevent re-contracture. If they were done, then you will need a biologic material placed (acellular dermal matrix) after the capsulectomy to reduce risk of recurrence.

You need to go smaller and release the capsule again on the higher side so that the implant settles down nicely. Right after surgery, you need to wear the band to keep the implant in its place and not rise up too high.

Hi. It appears that you have a capsule contractor. This appears to be the initial problem as well at least in some part. It seems to be a recurrence. Identify whether there is a change in firmness.

Recurrent capsule contractions are very difficult to correct, but can be done with the use of, a cellular dermal matrix.

I suggest you follow up with your plastic surgeon. It looks like you’re developing a recurrent capsular contraction.
There are a few reasons patients may develop capsular contractions. Some patients will develop recurrent capsular contractions. When that’s the case, there may be a bacterial contamination with an organism called staphylococcus epidermidis. This bacteria is very slow, growing, cannot be treated and is very difficult to isolate or test for. The diagnosis is usually a diagnosis of exclusion.
It is most likely the most common reason patients have recurrent capsular contractions. Because it can’t be tested, for there is no treatment other than capsulectomy, confirming sub muscular implant placement.
You may or may not be having a recurrent capsular contraction.
Before making any assessments, you need to be evaluated because it’s difficult to confirm if you have a capsular contraction by pictures alone.
I suggest you follow up with your plastic surgeon or schedule in person second opinion consultations.
Best,
Mats Hagstrom, MD