What is the simplest fix for waterfall breast deformity? (Photo)

Question

I got implants 9 years ago. The left implant never dropped. The doctor said he would fix it at no charge but it could end up worse. I was afraid it would look worse so just lived with it. In the last year it’s gotten really obvious and I need some help. What is the simplest fix?

Daniel Barrett, MD · Answer

Dear mlwatson1971,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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice almost 30 years and revisionary breast surgery is a large portion my practice.  You definitely have a waterfall deformity.  This is a relatively easy fix with a lift and excision of inferior pole breast tissue.  I fixed this type of deformity many times with excellent results.  Best wishes to you.

Gerald Minniti, MD, FACS · Answer

9 years is a long time and things can happen, including changes to the capsule around the implant, which would affect the nature and position of the implant, as well as soft tissue changes like generalized aging and patient specific loss of soft tissue support. It's clear that the left implant hasn't dropped, but what's not clears is how it might look after capsulectomy, allowing it to sit in a better position. If you are happy with your right breast, then maybe that's all that's necessary, with the exception of changing out the implants. If you would like to see your right breast look better, then a breast lift is in order. A better prognosis could be made with in person examination, which would optimize the surgical plan.

Gary M. Horndeski, MD · Answer

You may have a capsular contracture on the higher breast.  This may need to be released.  The best way to achieve symmetry is to do both breasts simultaneously.  You may benefit from a circumareola approach to reposition the nipple-areola complex as well as pocket revision.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

A front view would have been very helpful. However, you have a capsule which needs to be released to let the implant settle down. Once down, the position of the nipple needs to be checked to see if a lift is needed on that side.

What is the simplest fix for waterfall breast deformity? (Photo)

Answers (7)

Answer: Revision

Answer: Revision

Answer: Breasts

Answer: Breasts

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Everything you need to know about Breast Implant Revision

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What is the simplest fix for waterfall breast deformity? (Photo)

Answers (7)

Answer: Revision

Answer: Revision

Answer: Breasts

Answer: Breasts

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.