The waterfall effect in breast augmentation

Gland Surgery
James Frame

Abstract

The 'waterfall effect' is a descriptive term to indicate a sliding ptosis of parenchymal breast tissue over a fixed or encapsulated implant. It occurs more frequently than surgeons anticipate and especially over the longer term after augmentation. Certain breast implants are more prone to contribute to this problem as are implants placed in submuscular pockets that ride high, especially in women with anatomical musculoskeletal variance or asymmetry. This article describes the aetiology of sliding ptosis in more detail, the relevant anatomy and the surgical correction. Understanding the problem enables the surgeon to plan the appropriate procedure and obtain proper informed consent. It is possible that a two stage procedure is necessary should the upper pole of breast require a debulk, either early (3 to 12 months) or later as the breast may slide with ageing of the tissues. The waterfall effect of breast parenchyma over implants is only apparent when the upper torso of the woman is undressed and she is in an erect posture. A significant number of women are happy with this situation and therefore no further action is required. Those that want an improved appearance in these circumstances can try autologous fat transfer to rebulk...Continue Reading

Citations

Jun 22, 2018·Aesthetic Plastic Surgery·Denis Souto Valente
Jan 28, 2020·Plastic and Reconstructive Surgery·Amiram Borenstein, Yoav Abrahami
Jan 17, 2020·Plastic and Reconstructive Surgery. Global Open·Vincenzo VindigniTito Brambullo
Jan 23, 2020·Annals of the Royal College of Surgeons of England·D Perry, J D Frame
May 12, 2021·Plastic and Reconstructive Surgery·Tim K WeltzMikkel Herly
Apr 24, 2021·Plastic and Reconstructive Surgery·Maurizio NavaNicola Rocco
Jun 15, 2021·Seminars in Plastic Surgery·Brad D DenneyPallavi A Kumbla

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