Waterfall Breast Deformity – Causes and Solutions

By Dr Jake Lim – Plastic Surgeon | Updated: March 26, 2024

Causes, Treatments and Prevention of Waterfall Breast Deformity

Waterfall breast deformity, a term frequently used in the cosmetic surgery world, is a condition you might not have heard of, yet its impact on women’s lives is substantial. It refers to a post-augmentation condition where the breast tissue descends while the implant remains high on the chest wall, creating an ‘overhang’ or a ‘waterfall’ effect. This phenomenon is not a disease but can result from complications after breast augmentation surgery.

As you research more about cosmetic surgery, you might come across different terminologies that might seem intimidating or complex. But understanding these terms can help you make informed decisions about your health and body. In this blog, Sydney Plastic Surgeon Dr Jake Lim aims to shed light on one such term – waterfall breast deformity.

Decoding this condition is essential, especially if you’re considering breast augmentation surgery. Knowing what could go wrong, why it happens, and how it can be prevented or treated will equip you with the knowledge to navigate your journey effectively.

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What Causes Waterfall Breast Deformity?

The primary question that might be swirling in your mind is, “What causes waterfall breast deformity?” It’s essential to understand that this condition is not a disease in itself but rather an unfortunate outcome that can occur post breast augmentation surgery.

The primary cause of this deformity is the displacement of the breast tissue. In an ideal scenario, the implant and the breast tissue should move together, maintaining a natural effect. However, due to factors like surgical techniques, implant type, or inadequate support, the implant may remain high on the chest wall while the breast tissue descends, leading to the waterfall effect.

Ageing and gravity also play a significant role in causing this deformity. As you age, your skin loses elasticity, leading to sagging breasts. The medical terminology for this is Breast Ptosis. If you have breast implants, the natural tissue might sag while the implant remains in its original position, creating a waterfall deformity.

Understanding Snoopy Nose Breasts

You might also come across the term ‘snoopy nose breasts.’ This term, derived from the famous cartoon character Snoopy, and also refers to the waterfall breast deformity, where the breast tissue droops off the implant, resembling Snoopy’s nose.

The snoopy nose deformity can occur when the implant is placed above the muscle, and the breast tissue sags over time. This condition can also occur if the implant is larger than the existing breast tissue, causing the tissue to stretch and sag.

Common Symptoms of Waterfall Breast Deformity

Now that we’ve covered what causes waterfall breast deformity and the concept of snoopy nose breasts, let’s talk about the symptoms you should be aware of. It’s important to recognise the range of signs that can indicate this condition.

The most immediate and noticeable symptom is a distinct visual alteration in the shape and contour of the breasts. This can manifest as a pronounced discrepancy between the position of the breast tissue and the implant itself, where the breast tissue appears to drape or cascade over the implant, creating a noticeable ‘step-off’ at the edge of the implant. This can be particularly evident when leaning forward or when viewed from the side.

In addition to these visual cues, many women report a sensation of discomfort or even sharp pain, which can be attributed to the unnatural tension created by the disparity in the positioning of the breast tissue and the implant. The breast tissue, which is subject to the effects of gravity and ageing, tends to sag downwards, while the implant, often unaffected by these factors, remains unnaturally high on the chest wall. This can create a pulling sensation and may even lead to chronic pain, particularly in the lower part of the breast where the tissue is being stretched.

Patients may feel the implant more prominently in the upper chest area, which can be unsettling and uncomfortable. This is often accompanied by skin stretching and thinning, which not only contributes to the discomfort but can also lead to a heightened sensitivity and vulnerability to skin damage in the affected area.

Moreover, the symptoms can extend beyond physical appearance and discomfort. The constant awareness of the breast implants due to the deformity can lead to a preoccupation with the issue, causing anxiety and even depression in some cases. The psychological toll can be as significant as the physical discomfort, making it imperative for those experiencing these symptoms to seek professional advice.

It is crucial for anyone experiencing these symptoms to consult with a specialist plastic surgeon who performs breast surgery regularly. Dr Jake Lim can provide a thorough assessment and discuss potential corrective options. Understanding these symptoms is the first step toward addressing the condition and moving towards a solution that can improve the appearance.

Diagnosis of Waterfall Breast Deformity

If you suspect that you might have waterfall breast deformity, the first step is to seek a professional diagnosis. A consultation with a plastic surgeon can help determine if you have this condition and what the possible solutions might be.

During this consultation, Dr Lim will evaluate your breasts, analyse your symptoms, and consider your medical history. Dr Lim might suggest getting imaging an ultrasound to better examine the implant and tissue placement.

It’s essential to be open and honest about your symptoms and concerns during this consultation. Remember, this consultation is your opportunity to gather information and understand your condition better.

Solutions for Waterfall Breast Deformity

When addressing the solutions for Waterfall Breast Deformity, it’s essential to consider a spectrum of interventions tailored to the severity of the condition and your personal health goals. After a thorough diagnosis by Dr Jake Lim, you can explore a variety of treatment pathways.

Non-Surgical Treatments: Non-surgical interventions are often the first line of approach for those with mild symptoms or for individuals who are not candidates for surgery due to medical reasons or personal preference. These include:

  • Specialised Support Garments: High-quality support bras specifically designed for post-augmentation care can help alleviate some of the symptoms by providing extra lift and stabilisation for the breast tissue. These garments can be particularly beneficial in the short term and for those awaiting surgery
  • Physical Therapy: Some patients may benefit from physical therapy exercises that strengthen the chest muscles, potentially providing more support to the breast tissue and mitigating the sagging effect. This has only limited effect.

Surgical Solutions: For a more definitive and long-term correction, surgical options are available and can be customised based on your individual condition:

  • Implant Repositioning: This procedure involves adjusting the placement of the breast implant to a position that is more harmonious with the natural breast tissue, thereby reducing the ‘waterfall’ effect
  • Breast Lift (Mastopexy): A breast lift can be performed to remove excess skin and tighten the remaining tissue. When combined with implant repositioning, it can significantly improve the breast contour and address the waterfall deformity
  • Implant Exchange: In some cases, exchanging the existing implants for ones that are better suited to your anatomy can resolve the issue. This might include changing the size, shape, or type of implant (e.g., switching from saline to silicone or from round to teardrop shape)
  • Fat Grafting: Fat grafting can be used to add natural tissue around the implant, providing a more gradual transition between the implant and the natural breast tissue

Each surgical procedure carries its own set of risks and benefits, and a detailed discussion with Dr Jake Lim is necessary to determine the most appropriate course of action. Dr Lim will consider factors such as your anatomy, previous surgeries, the position and condition of the implants, and overall health status.

Post-Surgical Care

Post-operative care is also a critical component of the treatment plan. Following surgery, you may need to wear specific support garments, engage in limited activity, and follow a tailored plan for recovery to ensure the best possible outcome.

Psychological Support

Given the emotional impact of Waterfall Breast Deformity, solutions should also encompass psychological support. Counselling or participation in support groups can be beneficial for dealing with the emotional aftermath of living with the deformity and undergoing corrective procedures.

Ultimately, the goal of any treatment for Waterfall Breast Deformity is to restore both the aesthetic appearance and the functional comfort of the breasts. It’s important for you to have realistic expectations and to understand that while treatments can significantly improve the condition, perfection is not always achievable. The success of the treatment should be measured in terms of improvement in symptoms and satisfaction with the outcome.

Prevention Strategies for Waterfall Breast Deformity

Preventing Waterfall Breast Deformity involves a multifaceted approach that begins even before a you undergo breast augmentation surgery. By taking proactive steps, potential risks can be minimised. Here are several strategies that can be implemented to help prevent this condition:

1. Careful Selection of a Qualified Surgeon

Ensure that your plastic surgeon is board-certified and has extensive experience in breast augmentation and reconstruction surgeries. An experienced surgeon is more likely to understand the nuances of implant placement and the techniques that reduce the risk of post-operative complications like Waterfall Breast Deformity.

2. Comprehensive Pre-Surgical Consultation

A thorough discussion with your plastic surgeon about your aesthetic goals, lifestyle, and any concerns you have is crucial. This is the time to address the potential risks of deformities and understand what measures will be taken to prevent them.

3. Appropriate Implant Selection

Choosing the right implant size and shape is essential. Implants that are too large for the natural breast tissue or chest wall may increase the risk of deformities. Your plastic surgeon should help you select an implant that complements your body’s natural anatomy.

4. Optimal Implant Placement

The placement of the implant, whether above or below the muscle, can impact the likelihood of developing Waterfall Breast Deformity. Submuscular placement (below the chest muscle) may reduce the risk of this condition, especially in thin patients or those with little natural breast tissue.

5. Post-Operative Care and Follow-Up

Adhering to post-operative care instructions is vital for healing and maintaining the position of the implants. Regular follow-up appointments allow your surgeon to monitor your recovery and address any early signs of complications.

6. Supportive Garments

After surgery, wearing a supportive bra that provides adequate compression and lift can help maintain the position of the implants and breast tissue, especially during the healing process.

7. Lifestyle Considerations

Maintaining a stable weight through a balanced diet and regular exercise can prevent fluctuations in breast size that might contribute to tissue stretching and sagging. Avoid smoking, as it can impair healing and affect skin elasticity.

8. Awareness of Ageing and Gravity Effects

As part of the natural ageing process, skin elasticity diminishes. Being aware of this can help in making informed decisions about the timing of your surgery and the need for potential future revisions.

9. Early Intervention

If you notice changes in the appearance of your breasts post-surgery, consult your surgeon promptly. Early intervention can prevent more severe deformities from developing.

10. Consideration of Non-Implant Options:

For some women, considering breast augmentation alternatives like fat grafting may present fewer risks of deformities like Waterfall Breast Deformity.

FAQs about Waterfall Breast Deformity


Can exercise or physical therapy correct a Waterfall Breast Deformity?

  • While exercise and physical therapy can strengthen the muscles around the chest and improve overall breast support, they cannot correct a Waterfall Breast Deformity once it has occurred. This condition is related to the position of the breast implant relative to the breast tissue, and no amount of exercise can reposition an implant that has settled too high on the chest wall. Certain exercises may be recommended post-surgery to facilitate recovery and improve muscle tone, which can contribute to a better overall aesthetic result.

Are there any non-surgical alternatives to manage the appearance of Waterfall Breast Deformity?

  • Non-surgical alternatives, such as wearing specialised bras that provide extra lift and support, can manage the appearance of Waterfall Breast Deformity to some extent. These bras may help to camouflage the deformity under clothing and can provide some relief from discomfort. They do not address the underlying issue of implant position and are therefore considered a temporary management strategy rather than a corrective solution.

How long does it typically take to recover from surgery to correct Waterfall Breast Deformity?

  • Recovery time after surgery to correct Waterfall Breast Deformity can vary depending on the extent of the surgery and the individual’s healing process. Generally, patients may expect to take it easy for the first 2-4 weeks, avoiding heavy lifting and strenuous activities. Most can return to normal activities within 6-8 weeks. Full recovery, where the final results are evident, and the tissues have settled, may take several months. Dr Jake Lim will provide a detailed recovery timeline based on your specific surgical plan.

Further Reading about Breast Augmentation Surgery with Dr Jake Lim

Medical References about Waterfall Breast Deformity

About Dr Jake Lim

Highly qualified and experienced specialist plastic surgeon Dr Jake Lim focuses on facial plastic, cosmetic breast and body contouring after significant weight loss

Dr Lim creates the best possible plastic surgery results for his Australia-wide and international patients.

Dr Lim is passionate about making sure each and every patient has access to the right information about available treatments and procedures and is able to make well-informed decisions.

At My Klinik, patient safety, education and achieving optimal results are our top priorities.