Breast Implants

Waterfall Breast Deformity after Breast Implant Surgery

What Is Snoopy Nose Deformity?

Breast augmentation surgery, a popular choice for women seeking to enhance their appearance and self-confidence, has been an important procedure for many patients. While the procedure often yields satisfying results, it is not without its potential complications and nuances. One such complication that can arise after breast implants surgery is the Waterfall or Snoopy Nose Breast Deformity.

Snoopy Nose Breast Deformity is a condition that can impact the aesthetic outcome of breast augmentation, leading to a distinct and sometimes unsettling appearance. Understanding this deformity, its causes, and available solutions is crucial for both prospective patients and those who may have already experienced it. In this blog, Chester Consultant Plastic Surgeon Anca Breahna PhD, MSc, FEBOPRAS, FRCS (Plast) with expertise in Aesthetic and Reconstructive Plastic Surgery, will discuss the intricacies of Snoopy Nose or Waterfall Breast Deformity after breast implant surgery, providing insight into its definition, causes, symptoms, diagnosis, treatment options, and prevention measures.

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What Is a Waterfall Deformity?

Waterfall Deformity, also referred to as “Snoopy Nose Deformity,” is a term used to describe a specific and sometimes visually noticeable issue that can affect the appearance of augmented breasts. This condition gets its name because of its characteristic appearance, which resembles the sloping shape of a waterfall or the profile of the cartoon character Snoopy’s nose.

The primary feature of a Waterfall Deformity is a downward displacement of the breast tissue below the implant, causing the augmented breast to take on an unnatural appearance. In essence, it creates a “waterfall” effect, where the breast mound seems to slide or droop below the position of the implant. This can result in a less-than-ideal aesthetic outcome, which may leave individuals dissatisfied with the appearance of their augmented breasts.

Causes and Risk Factors

Waterfall Deformity after breast implant surgery can arise from a combination of factors that influence the position and behaviour of the implants within the breast tissue. Understanding these causes and risk factors is essential for patients contemplating breast augmentation. Here’s a more detailed exploration of these contributing factors:

  1. Implant Size and Weight: The size and weight of the breast implants are crucial factors. Larger and heavier implants exert more gravitational force on the breast tissue, increasing the likelihood of downward displacement over time. Patients seeking significantly larger breast sizes should be particularly aware of this risk
  2. Implant Placement: The placement of the implant is a critical decision made during breast augmentation surgery. There are two primary options: subglandular (above the chest muscle) and submuscular (below the chest muscle). Submuscular placement in women with relatively saggy breasts is associated with a higher risk of Waterfall Deformity because the mobile breast tissue can slide over the implant capsule.
  3. Tissue Characteristics: The inherent characteristics of a patient’s breast tissue play a pivotal role. The natural elasticity and strength of breast tissue can affect how the implant settles and maintains its position. Women with less elastic breast tissue may be more susceptible to this deformity
  4. Implant Type: The choice between various types of silicone implants can influence the risk of Waterfall Deformity. Polyurethane-coated implants, because they bio-integrate in the surrounding tissues and are less mobile may have a greater propensity to create this effect.
  5. Surgical Technique: The expertise and surgical technique of the plastic surgeon can significantly impact the outcome. A surgeon skilled in breast augmentation procedures and knowledgeable about the nuances of implant placement is less likely to create conditions conducive to Waterfall Deformity. Proper pocket creation and meticulous handling of breast tissue are essential
  6. Anatomical Factors: Each individual has a unique breast anatomy. Anatomical factors, such as the presence of ptosis (breast sagging) or asymmetry, can contribute to the development of this deformity. Pre-existing breast characteristics may require customised surgical approaches to minimise the risk

Signs of Waterfall Deformity

Waterfall Deformity is identifiable through specific visual and physical indicators. Symptoms associated with this condition include:

  • Gap Between the Implant and the Breast Mound: A distinct gap may become visible between the implant located at the upper pole and the ptotic breast tissue, creating a noticeable separation
  • Low Nipple-Areola Complex: The nipple-areola complex may appear lower on the breast mound than desired, contributing to the unnatural appearance
  • Breast Sagging: The lower portion of the breast may appear to sag or droop, contributing to the characteristic “waterfall” shape

Diagnosis of Waterfall Deformity

Diagnosing Waterfall Breast Deformity is a critical step in addressing and resolving this condition effectively. Accurate diagnosis not only confirms the presence of the deformity but also helps determine the extent of the issue and plan appropriate treatment strategies. Here’s an in-depth look at how we diagnose this condition:

Clinical Examination:

  • Anca Breahna often starts with a thorough clinical examination. During this examination, she evaluates the patient’s breasts, taking note of any visual irregularities, such as the drooping of the lower breast
  • She will also assess the position of the nipple-areola complex in relation to the breast mound and the implant

Patient History:

  • Gathering a comprehensive patient history is crucial. This includes information about the type of implants used, their size, the surgical technique employed, and any pre-existing breast conditions or concerns
  • Patients should openly communicate their post-surgery experiences, including any discomfort, changes in breast appearance, or other symptoms

Imaging Techniques:

  • To provide a more precise evaluation, imaging techniques like mammograms or MRI scans might be required. These imaging studies can offer a detailed view of the breast tissue, the implant’s position, and any potential issues
  • Ultrasound: High-resolution US scans can assess the position and integrity of breast implants and detect any abnormalities or malpositioning. Ultrasound, while less expensive than MRI, it is also less reliable than MRI and may report a false positive/negative
  • MRI (Magnetic Resonance Imaging): MRI scans provide a more comprehensive view of the breast and the implants. They are particularly valuable for assessing the integrity of the implant shell and identifying any issues related to implant placement and position
  • Mammogram: Mammography, although primarily used for breast cancer screening, can also reveal the position and characteristics of breast implants.

Waterfall Breast Deformity – Treatment Options

Surgical procedures are available to correct this deformity and restore a more natural and aesthetically pleasing breast appearance. Next, we will discuss surgical correction options commonly used for Waterfall/Snoopy Nose Breast Deformity, along with insights into the recovery process and potential risks associated with surgery:

Surgical Procedures for Correction of Snoopy Nose Breast Deformity

  • Implant Exchange: In cases where the implant size or type contributes to the deformity, one of the primary correction methods is implant exchange. This involves removing the existing implants and replacing them with smaller or differently shaped implants that are better suited to the patient’s desired outcome. For example, switching from round to anatomically shaped implants may help create a more natural breast contour
  • Breast Uplift (Mastopexy): A breast uplift procedure, or mastopexy, can be a crucial component of correcting Snoopy Nose Breast Deformity, particularly when the nipple-areola complex has been displaced. During a breast uplift, excess skin is removed, and the breast tissue is reshaped and repositioned to achieve a more balanced appearance. This can help address both the implant malposition and any sagging
  • Internal Bra Techniques: In some cases, the internal bra technique can provide additional support to the implants and breast tissue. This can involve using sutures or surgical mesh to secure the implant in a desired position, preventing further downward displacement

Recovery Process

The recovery process following surgical correction for Waterfall/Snoopy Nose Breast Deformity typically includes the following key aspects:

  • Postoperative Care: After surgery, patients will need to follow Anca’s postoperative care instructions diligently. This may include wearing compression garments, taking prescribed medications, and attending follow-up appointments
  • Rest and Activity: Patients should expect to limit strenuous physical activities for a period specified by their surgeon. Rest and gentle movements are essential during the initial recovery phase to promote proper healing
  • Swelling and Bruising: Some degree of swelling and bruising is common after surgery. This subsides gradually over several weeks
  • Return to Normal Activities: The timeline for returning to normal daily activities and exercise will vary depending on the extent of the surgical correction and individual healing rates. Patients should refrain from any activity that may strain the surgical site until cleared by their surgeon

Potential Risks

Surgical correction for Waterfall/Snoopy Nose Breast Deformity, like any surgical procedure, carries certain risks and potential complications. These can include:

  • Infection: There is a risk of infection at the surgical site, which can be mitigated through proper wound care and antibiotic use
  • Scarring: Surgical incisions will result in some degree of scarring. Anca aims to minimise scarring by placing incisions strategically and using techniques to promote healing
  • Changes in Sensation: Alterations in nipple or breast sensation may occur, although they are often temporary
  • Implant-Related Complications: Depending on the procedure, there may be implant-related complications, such as implant rupture or malposition
  • Anaesthesia Risks: There are inherent risks associated with anaesthesia, which should be discussed with the anaesthesiologist and plastic surgeon before the procedure

Prevention of Snoopy Nose after Getting Breast Implants

While Waterfall Breast Deformity can be addressed through surgical correction, prevention is always preferable. Taking proactive steps before and after breast implant surgery can help minimise the risk of developing this condition and ensure a more successful and satisfying outcome. Here are some important tips and recommendations for prevention:

  • Consult with a Qualified Plastic Surgeon: Begin your breast augmentation journey by selecting a talented and experienced plastic surgeon. A skilled surgeon will not only perform the procedure meticulously but also provide valuable guidance and recommendations tailored to your unique anatomy and goals
  • Communicate Your Goals and Concerns: During your consultation, be clear and open about your goals and concerns. Discuss your desired breast size, shape, and the look you hope to achieve. Your plastic surgeon should be aware of any potential issues or asymmetries in your breast anatomy
  • Implant Selection: Work closely with your plastic surgeon to choose the right implant type, size, and shape that aligns with your goals while considering your body’s natural proportions. Avoid overly large implants, as they may increase the risk of implant malposition over time
  • Implant Placement: Discuss the pros and cons of implant placement options (subglandular vs. submuscular) with your surgeon. Submuscular placement tends to provide more support and minimise the risk of implant displacement
  • Surgical Technique: Inquire about your surgeon’s preferred surgical techniques and their approach to minimising the risk of Waterfall Breast Deformity. Techniques that involve proper pocket creation and suturing may enhance implant stability
  • Pre-existing Breast Conditions: If you have any pre-existing breast conditions, such as mild ptosis (sagging), be sure to discuss them with your surgeon. They may recommend additional procedures like a breast lift (mastopexy) in conjunction with augmentation to achieve the best results
  • Follow Postoperative Instructions: After surgery, diligently follow your surgeon’s postoperative instructions. This includes wearing any recommended support garments and attending all follow-up appointments
  • Regular Check-ups: Schedule regular follow-up appointments with your plastic surgeon to monitor the condition of your breast implants. Early detection of any issues can lead to timely intervention

FAQs about Waterfall Breast Deformity after Breast Implants Surgery

What is a Waterfall/Snoopy Nose Deformity, and how does it differ from other breast implant complications?

  • A Waterfall/Snoopy Nose Deformity is a specific complication of breast augmentation characterised by a downward displacement of the breast tissue below the implant with a distinctive waterfall appearance. Unlike some other complications, it primarily concerns the position and shape of the breast tissue itself, rather than issues with the implant like implant rupture or capsular contracture.

Can Waterfall/Snoopy Nose Deformity occur with any type of breast implant (saline or silicone)?

  • Yes, Waterfall/Snoopy Nose Deformity can potentially occur with both saline and silicone implants. However, the risk may vary depending on the specific characteristics of the implant, such as size and weight. Discussing implant options and their associated risks with your plastic surgeon is essential to minimise this complication.

Is a Waterfall/Snoopy Nose Deformity always immediately apparent after breast augmentation surgery?

  • No, Waterfall/Snoopy Nose Deformity may not always be immediately noticeable. In some cases, it can develop gradually over time as the breast tissue and implant settle. Patients should be vigilant about postoperative changes and regularly follow up with their plastic surgeon to detect and address the condition early if it arises.

Can a Waterfall/Snoopy Nose Deformity be corrected with non-surgical methods or exercises?

  • While some mild cases may benefit from non-surgical approaches like supportive bras or specific exercises, surgical correction is often necessary for moderate to severe Waterfall/Snoopy Nose Deformity. Surgical techniques such as implant exchange and breast uplift (mastopexy) are typically employed to restore a natural breast appearance.

Is there a way to prevent a Waterfall/Snoopy Nose Deformity from occurring after breast implant surgery?

  • Prevention involves several strategies, including careful implant selection, choosing an experienced plastic surgeon, and maintaining a healthy lifestyle. Minimising implant size, discussing implant placement options, and addressing pre-existing breast conditions during consultation can also help reduce the risk. Regular follow-ups with your plastic surgeon and adherence to postoperative instructions are crucial in early detection and intervention if Snoopy Nose Deformity does develop.

Further Reading about Breast Surgery with Consultant Plastic Surgeon Anca Breahna

Medical References about Waterfall Breast Deformity

Anca Breahna - Plastic Surgeon

Miss Anca Breahna is a Consultant Plastic Surgeon in Chester UK. She performs Breast, Face and Body Surgery at Nuffield Hospital Chester as well as Minor Surgery, Skin and Hand Procedures in her rooms at Cheshire Cosmetic Surgery. Dr Anca Breahna FRCS (Plast) is proud to be one of the few leading female Plastic, Reconstructive and Cosmetic surgeons in the UK serving people primarily across Cheshire, Merseyside, North Wales and The Wirral. She is an experienced UK-trained plastic surgeon with multiple awarded fellowships since completing her training. With her commitment to the highest possible standard of care, Miss Breahna aims to bring you the epitome of excellence in cosmetic surgery, well-being and results, ensuring your surgical journey is a successful one.