What Is The Waterfall Effect? – Potential Complication after Breast Implants Surgery

Waterfall deformity breast implants

The Snoopy Dog Deformity after Getting Breast Implants

Between 5 to 10 million women worldwide have breast implants. Around 30% of women remove or exchange their implants within ten years after breast augmentation surgery because of a breast implant deformity or complication.  The waterfall effect or the snoopy dog deformity is a kind of breast implant deformity. It happens when loose breast tissue slides off and over the breast implant. As a result, the breast tissue appears to be sagging below the implant.

The most effective way to correct the waterfall effect in breast implants is by breast lift surgery (mastopexy) with or without implant replacement. The breast lift can also be combined with autologous fat grafting to repair a snoopy dog implant deformity.

Learn more about the waterfall effect after getting breast implants, what it looks like, what causes it, and how to manage it.

What Is The Waterfall Effect Or Snoopy Dog Deformity In Breast Implants?

The waterfall effect, also known as snoopy dog breast deformity or snoopy dog syndrome, is a breast contour deformity that can develop after breast augmentation surgery, especially with subpectoral (under the muscle) implants.

This breast implant complication happens when the natural breast tissue slides down over the implant and falls below it.

Women with snoopy dog breast implant deformity have a volume of sagging breast tissue visible below the breast implant.

What Does A Waterfall or Snoopy Dog Deformity Look Like? 

This breast implant complication is known as the waterfall effect because the breast tissue looks like it’s spilling over the implant resembling a waterfall.

It’s also known as a snoopy dog or a snoopy nose deformity because the sliding (ptosis) of breast tissue creates the appearance of a sad cartoon snoopy dog with its nose pointing down.

The waterfall or snoopy nose deformity is often confused with the double bubble deformity, another post-breast implant surgery complication.

The main difference is that a double bubble deformity happens when the implant drops below the native breast fold. On the other hand, with a snoopy nose deformity, the breast implant stays in place, and the breast tissue falls over and below the implant.

You can search online for before and after pictures of breast implant deformities to check whether you have a snoopy dog, waterfall, or double bubble deformity. An experienced plastic surgeon can confirm what type of breast implant deformity you have.

What Causes Waterfall Effect after Breast Augmentation Surgery?

The waterfall effect after breast augmentation surgery is caused by the sliding of natural breast tissue over the breast implant.

The breasts consist of three main kinds of tissues: glandular tissue, connective tissue, and fat tissue. The bulk of fat or adipose tissue helps support the breast and the rest of its tissue.

The loss of supporting fat from the breast is the main reason for developing the waterfall effect after breast implant surgery. Without sufficient fatty tissue, the rest of the breast tissue becomes loosened and can slide down over the implant, leading to snoopy nose breast deformity.

The snoopy dog or waterfall deformity most commonly occurs with submuscular breast implants that are positioned too high up on the chest. High-riding submuscular implants allow any overlying loose breast tissue to slide over the fixed implant.

What Are The Risk Factors of Waterfall Deformity?

There is a higher risk to develop a snoopy dog breast implant deformity after breast augmentation surgery if:

  • You are following a Yo-yo diet: Yo-yo dieting or “weight cycling” is a process of losing weight, regaining it, and then losing it again. Women on the Yo-yo diet have a higher risk of waterfall deformity after breast implant surgery because weight fluctuations can affect the volume of breast fat tissue
  • You had multiple pregnancies: during pregnancy, the breasts become engorged, then deflate after childbirth. Moreover, during lactation and breastfeeding, the glandular breast tissue expands 3 to 5 times and damages the fatty breast tissue. After several pregnancies, the breast tissues can become loosened and more prone to sliding, which increases the risk of snoopy breasts after breast augmentation surgery
  • You are a certain age: with age, your skin becomes more relaxed, and your breasts start to droop, which can result in a breast implant deformity
  • You have high-riding submuscular implants: when submuscular implants are placed high on the chest, it becomes easier for loose overlying breast tissue to spill over
  • You have Polyurethane implants: the waterfall deformity can also happen with subglandular (over the muscle) implants, specifically polyurethane subglandular breast implants. The polyurethane implants can become adhered to deeper breast tissue. As a result, any overlying loose breast tissue can slide over the fixed polyurethane implant capsule

How to Correct Waterfall Deformity?

The waterfall effect after getting breast implants usually isn’t apparent when the breasts are covered. Therefore, some women choose not to correct a snoopy dog deformity, especially if their breasts look good in a bra or under clothes.

For other women, the snoopy deformity can be very aesthetically unpleasant and cause a lot of frustration.

Your surgeon can recommend different solutions to a snoopy breast deformity depending on your skin type, breast anatomy, and the degree of breast scarring from your original breast implant surgery.

1.     Remove the implants

The waterfall effect will disappear if the surgeon removes the breast implants without replacing them. However, the breasts will lose fullness from the implants, which can leave patients disappointed with the appearance of their breasts.

2.     Replace and reposition the breast implants

To correct a snoopy breast deformity, your surgeon can remove your implants and replace them with more projecting implants or ones with a different style and shape.

While replacing your implants, your surgeon could either keep them in the same submuscular position or reposition them in front of the muscle to avoid another waterfall deformity.

3.     Breast lift with or without implant replacement

A breast lift, or mastopexy, can repair the waterfall deformity by lifting and repositioning the droopy breast tissue back over the implant.

That is the most common way to repair a snoopy nose breast deformity and can be done with or without replacing and repositioning the breast implants.

4.     Autologous fat transfer

Autologous fat transfer involves harvesting fat from the tummy or thighs and then strategically injecting it into the breasts.

The grafted fat can add volume to and re-bulk the breast tissue surrounding the implant.

In some cases, surgeons can combine autologous fat transfer with a breast lift to repair the appearance of snoopy breast implants.

Women with a sufficient amount of breast tissue who wish to improve the appearance of their sagging breasts can get a breast lift with or without fat transfer instead of breast implant surgery. That can help them reshape their breasts without implants and avoid snoopy nose deformity and other breast implant complications.

If you’re looking to fix the appearance of your breasts after a breast implant surgery, consult a highly skilled and experienced plastic surgeon. A mastopexy augmentation surgery requires immense surgical skills to correct a snoopy dog breast deformity while limiting additional breast scars.

Medical References about Waterfall Deformity

Further Reading Related to Waterfall Effect