Dr. Mark Kohout, a distinguished plastic surgeon based in Sydney, Australia, brings over 25 years of expertise in cosmetic surgery. His extensive training includes fellowships at prestigious institutions, such as the Royal College of Surgeons in England and Edinburgh, as well as advanced training at Harvard Medical School. Dr. Kohout has built a strong reputation for his expertise in a variety of surgical procedures, particularly breast surgery, including augmentations, lifts, and reductions. His dedication to patient care is evident through his individualized consultations, ensuring that each patient’s unique needs and concerns are thoroughly addressed.
Beyond his surgical practice, Dr. Kohout is a published author and a regular contributor to discussions on cosmetic surgery in the media. As a member of the Australian Society of Plastic Surgeons and a Fellow of the Royal Australasian College of Surgeons, Dr. Kohout is recognized for his dedication to personalized care and innovative treatments, such as Morpheus8. In this blog, we explore breast correction, specifically addressing a complication known as “waterfall deformity.”
Breast Correction: Understanding Waterfall Deformity
Waterfall deformity is a term used to describe a specific type of breast shape distortion that can occur after breast augmentation or reconstruction. It is characterized by an unnatural ptotic (drooping) appearance of the breast tissue, resembling a cascading waterfall. This deformity can result from various factors, including improper implant placement, inadequate tissue support, or complications during the healing process.
Breast augmentation and breast lift surgeries (Breast correction surgery) have greatly improved aesthetic outcomes for many patients, helping them achieve their desired appearance. However, as with any surgical intervention, complications can sometimes arise, and waterfall deformity is one such issue. Although treatable, this condition can be distressing for those affected. A comprehensive understanding of the underlying causes, symptoms, and corrective measures associated with waterfall deformity is crucial for patients considering or experiencing this condition.
What Is Waterfall Deformity?
Waterfall deformity, also known as “Snoopy breast deformity,” may occur following breast augmentation or mastopexy (breast lift) procedures. The condition is named for the way the natural breast tissue “falls” or droops over the breast implant, resembling a waterfall. Essentially, the breast implant remains positioned high on the chest, while the natural breast tissue descends below it, leading to a visually distinct dual contour.
This deformity often appears post-mastopexy, whether or not implants are involved, when the natural breast tissue does not integrate effectively with the reshaped breast mound. Improper implant placement, insufficient elevation of the breast tissue, or the natural physiological changes that breasts undergo over time may all contribute to the development of this condition. The dual contour, where the implant remains elevated while the natural tissue sags, can cause considerable distress for patients seeking a harmonious, balanced breast shape.
Causes of Waterfall Deformity
Waterfall deformity can arise from multiple factors, often related to the patient’s natural anatomy, surgical technique, or post-surgical factors. Key contributing factors include:
- Implant Placement: Implants positioned beneath the pectoral muscle (submuscular placement) can sometimes create a distinct separation between the implant and the natural breast tissue. When gravity causes the breast tissue to sag, the implant remains in place, leading to a dual contour effect. This is more pronounced in patients with a significant amount of natural breast tissue, as the weight of the tissue can cause it to descend below the implant.
- Inadequate Mastopexy: If, during a breast lift, the breast tissue is not adequately repositioned or tightened, the natural tissue may continue to droop below the implant. This is particularly common in patients with a significant amount of natural breast tissue, where insufficient lifting leads to an imbalance between the implant and breast tissue, contributing to the dual contour effect.
- Weak Breast Tissue Integrity: Patients with naturally weak or lax breast tissue, due to genetics, weight fluctuations, or prior pregnancies, are at a higher risk of developing waterfall deformity. Such tissue is more prone to sagging, even after a lift or augmentation. Weak tissue may lack the structural support needed to maintain a firm, lifted appearance, which can lead to sagging below the implant.
- Ageing: The natural aging process also plays a significant role. Over time, skin loses elasticity, and the ligaments supporting the breast tissue weaken, leading to a sagging effect. Even with implants in place, the natural tissue may droop over time, resulting in waterfall deformity. As the skin and supporting tissues weaken, the implants may remain in their original position, while the breast tissue descends, creating the dual contour effect.
- Incorrect Implant Size: Selecting implants that are too large for the patient’s anatomy can increase the risk of waterfall deformity. Excessive implant weight can cause the natural tissue to sag, leading to an imbalance between the implant and breast tissue. Properly choosing an implant size that matches the patient’s anatomy is crucial to avoid these issues.
Identifying Waterfall Deformity
Diagnosing waterfall deformity typically requires a comprehensive clinical evaluation by a qualified plastic surgeon, like Dr. Mark Kohout. During this assessment, the surgeon will evaluate the breast’s shape, symmetry, and overall appearance, while discussing any concerns or symptoms the patient may have. In some cases, imaging studies such as ultrasound or MRI may be used to assess the implant’s position and identify any underlying issues contributing to the deformity.
Patients often describe their breasts as having a noticeable dual-layer effect, where natural breast tissue descends over the implant, resulting in an elongated breast shape with downward-pointing nipples. This visual discrepancy can be distressing, particularly when wearing clothing that accentuates the chest area. Patients may also experience both physical discomfort, such as skin irritation or tightness, and emotional dissatisfaction with their breast shape. This condition can further impact their confidence and quality of life, limiting clothing choices, such as swimsuits or low-cut tops.
Breast Implant Surgery Before and After Images
Preventing Waterfall Deformity
Preventing waterfall deformity starts with careful planning and choosing the appropriate surgical technique tailored to the patient’s unique anatomy and desired outcomes. Key preventive measures include:
- Choosing an Experienced Surgeon: Selecting a skilled and experienced plastic surgeon, like Dr. Mark Kohout, is crucial to achieving the best possible outcome. An experienced surgeon will consider various factors, such as skin elasticity, breast tissue quality, and patient expectations, to determine the optimal surgical approach. This expertise is key to preventing complications like waterfall deformity and achieving a balanced, natural result.
- Appropriate Implant Selection: Choosing an implant size that is proportional to the patient’s natural anatomy is important. Oversized implants can place unnecessary strain on the breast tissue, increasing the risk of sagging. Dr. Kohout works closely with each patient to select an implant size that complements their body proportions, reducing the likelihood of tissue drooping and creating a more harmonious breast shape.
- Correct Surgical Technique: During breast augmentation or lift, the surgeon must carefully assess the placement of the implant and the positioning of the natural breast tissue. In some cases, combining a breast lift with implant placement requires meticulous planning to ensure the natural breast tissue remains lifted and integrates seamlessly with the implant. Proper implant placement and tissue repositioning are critical to achieving a cohesive and balanced breast appearance.
- Post-Surgical Care: Adhering to post-operative care guidelines is essential for a successful surgical outcome. Patients should avoid activities that place undue stress on the chest muscles and wear a supportive bra as directed by their surgeon. This helps to ensure that the breasts heal properly and reduces the likelihood of complications such as waterfall deformity. Proper post-surgical care is vital in maintaining the position of the implants and supporting tissues during the healing process.
Correcting Waterfall Deformity
The most common treatment for waterfall deformity is breast correction surgery, which may involve repositioning the implants, removing excess skin, or performing a breast lift (mastopexy) to restore a more natural contour. If capsular contracture is present, a capsulectomy may be performed to remove the hardened scar tissue surrounding the implant. Fat grafting can also be used to enhance breast volume and improve contour without additional implants. Depending on individual circumstances, surgeons may recommend combining several techniques for optimal results.
Corrective options for waterfall deformity include:
- Revision Mastopexy: In cases where the breast tissue has sagged, a revision mastopexy (breast lift) may be required to reposition the tissue appropriately. This procedure involves removing excess skin, lifting the breast tissue, and ensuring that the nipple is in a more central, aesthetically pleasing position. This can help eliminate the dual contour effect and restore a more natural breast shape.
- Capsulorrhaphy: Capsulorrhaphy is a surgical technique used to adjust the implant pocket’s position. By modifying the pocket, the implant can be repositioned to achieve better alignment with the natural breast tissue. Capsulorrhaphy helps create a more unified contour by ensuring that the implant and breast tissue align properly.
- Changing Implant Placement: If waterfall deformity is related to submuscular implant placement, changing the implant to a subglandular (above the muscle) position may help the implant sit more naturally with the breast tissue. This adjustment can alleviate the appearance of drooping tissue over the implant and improve overall harmony.
- Fat Grafting: In some cases, fat grafting may be used to add volume to the upper part of the breast, balancing out the breast shape and reducing the prominence of sagging tissue. Fat grafting involves harvesting fat from another area of the body (such as the abdomen or thighs) and injecting it into the breast to enhance volume and improve contours.
- Implant Exchange: If the original implant is too large, replacing it with a smaller implant may alleviate strain on the breast tissue, reducing the risk of further sagging. This can help provide a more proportionate breast size and a natural, cohesive appearance.
Patient Experience and Emotional Considerations
Experiencing complications such as waterfall deformity can be challenging for patients, both physically and emotionally. Many patients undergo breast correction surgery to address their concerns. When the outcome is not as expected, it can lead to feelings of disappointment, frustration, or anxiety.
Patients should remember that complications like waterfall deformity are not uncommon and can be effectively treated. Consulting an experienced and compassionate plastic surgeon like Dr. Mark Kohout can make all the difference in achieving a successful outcome. Dr. Kohout’s approach involves understanding each patient’s concerns, providing thorough consultations, and developing a personalized corrective plan.
The psychological impact of waterfall deformity can be significant. Feelings of self-consciousness or dissatisfaction with one’s appearance may lead to decreased self-assurance and social withdrawal. Addressing these concerns through consultation with a qualified professional like Dr. Kohout can help patients regain their sense of self-worth and improve their body image.
The Importance of Personalised Treatment
Every patient is unique, and their surgical plan should reflect their individual anatomy, preferences, and goals. Waterfall deformity can occur due to various factors, and the corrective approach must be tailored to the specific circumstances of the patient. Whether the solution involves a revision lift, implant exchange, or fat grafting, a personalized approach is essential for achieving the best possible outcome.
Dr. Mark Kohout emphasizes the importance of customising each breast correction surgery plan to fit the patient’s needs. By taking into account factors such as skin quality, tissue elasticity, and breast shape, Dr. Kohout ensures that each procedure is designed to produce results that align with the patient’s aesthetic goals while managing the risk of complications.
Recovery After Breast Correction Surgery
Recovery after corrective surgery for waterfall deformity varies depending on the specific procedure performed. Patients can expect some swelling, bruising, and discomfort in the initial days following breast correction surgery. Dr. Kohout and his team provide detailed post-operative care instructions to encourage an uneventful recovery.
Patients are generally advised to avoid strenuous activities for several weeks and to wear a supportive surgical bra to help maintain the new breast shape during the healing process. Follow-up appointments are scheduled to monitor healing progress and address any concerns. Dr. Kohout’s comprehensive aftercare ensures that patients are supported throughout their recovery journey, both physically and emotionally.
Proper post-operative care is crucial for achieving the desired outcome and reducing the risk of complications. Patients should follow specific guidelines for wound care, activity limitations, and wearing compression garments to aid in the healing process. Dr. Kohout and his team are dedicated to providing ongoing support to patients throughout their recovery journey, ensuring they feel confident and well-cared-for every step of the way.
Achieving Long-Lasting Results
To achieve long-lasting results, it is important for patients to maintain a stable weight, follow a healthy lifestyle, and adhere to their surgeon’s post-operative guidelines. While ageing and gravity will continue to affect the breasts over time, choosing the right breast correction surgery techniques and implants can help ensure that results are enduring.
Dr. Mark Kohout’s approach to breast surgery focuses on achieving a harmonious balance between the breast implant and natural tissue, taking into account each patient’s unique anatomy and goals. By utilizing advanced surgical techniques and providing personalized care, Dr. Kohout helps patients achieve their desired outcomes.
To maintain long-lasting results, patients should maintain a stable weight and avoid significant fluctuations that could affect breast shape. Following a healthy lifestyle, including a balanced diet and regular exercise, can contribute to the longevity of surgical results. Dr. Kohout provides patients with guidance on post-surgical care to ensure that results remain favorable.
Waterfall deformity is a condition that can occur after breast augmentation or lift, resulting in a dual-layer appearance where the natural breast tissue sags over the implant. While this complication can be concerning, it is important to remember that effective corrective options are available. Choosing an experienced surgeon, such as Dr. Mark Kohout, is crucial in preventing and treating waterfall deformity.
Dr. Kohout’s extensive experience in breast surgery, combined with his personalized approach to patient care, ensures that each patient receives the treatment best suited for them.
Whether it involves revision mastopexy, implant exchange, or another corrective measure, Dr. Kohout is committed to helping patients achieve their optimal outcome.
If you are experiencing concerns about your breast surgery or wish to learn more about your options for correcting waterfall deformity, Dr. Mark Kohout is available to provide guidance and support. With careful planning, experienced surgical technique, and compassionate care, achieving an optimal outcome is possible. Dr. Kohout’s dedication to his patients and many years of experience make him a trusted choice for breast correction surgery. Whether you are looking to address waterfall deformity or explore other options, Dr. Kohout is here to help you achieve your desired outcome.
Further Reading about Breast Implant Surgery with Sydney Specialist Plastic Surgeon Dr Mark Kohout
- Read more about Dr. Mark Kohout’s Breast Implants Procedure
- Read more about Dr. Mark Kohout’s Recovery after Breast Implant Removal? Blog
- Read more about Dr. Mark Kohout’s Recovery After Breast Implant Removal: What to Expect and How to Navigate the Process Blog
- Read more about Dr. Mark Kohout’s Breast Implants Revisions: Assessing the Need for Surgery Blog
- Read more about Dr. Mark Kohout’s How Much Does It Cost To Get Breast Implants Removed? Blog
