Breast Revision & Tummy Tuck | Mommy Makeover Before After

Patient Overview

• Patient: Farah

• Age: 59 years old

• Gender: Female

• Occupation: Dentist

• From: United States

• Procedures: Revision Breast Surgery (Capsulectomy, Muscle Repair, Implant Pocket Conversion to Over-Muscle, New Implant Placement, Breast Lift, Volume Reduction), Tummy Tuck

• After photos taken at: 6 days post-surgery

• Previous surgery with Dr. CBS: Deep Plane Face & Neck Lift, Brow Lift, Blepharoplasty (6 months prior)

• Location: Istanbul, Turkey

A Returning Patient's Complete Transformation: Face, Breasts & Body

Farah is a 59-year-old dentist from the United States who came to Dr. Cem Berkay Sinaci in Istanbul for a comprehensive body transformation — but this was not her first surgery with Dr. CBS. Six months earlier, Farah had undergone a complete facial rejuvenation with Dr. CBS: a deep plane face and neck lift, brow lift, and upper and lower blepharoplasty. Satisfied with her facial results, she returned to Istanbul six months later to address her body — making her a returning patient for a second major surgical session.

This second surgery was a mommy makeover in the truest sense of the term: a complex revision breast surgery correcting a waterfall deformity caused by her previous submuscular implants, combined with a breast lift and tummy tuck. Farah's case is one of the most comprehensive total body and face transformations that Dr. CBS performs — a full head-to-body rejuvenation completed across two carefully planned surgical sessions, six months apart. These before and after photos were taken 6 days after her second surgery.

What Is Waterfall Deformity and Why Did It Happen?

Waterfall deformity — also known as Snoopy deformity or double bubble — is one of the most visually distinct complications of breast augmentation surgery. It occurs specifically when implants are placed beneath the pectoral muscle (submuscular placement) in a patient whose breast tissue has developed significant ptosis (sagging). The pectoral muscle holds the implant firmly in a high, relatively fixed position on the chest wall. Meanwhile, the natural breast tissue and skin — which are above the muscle — continue to sag and droop downward under gravity, unsupported by the implant beneath them.

The result is a characteristic split appearance: the implant projects forward from the upper chest, while the natural breast tissue waterfalls off the front and below the implant. The nipple is carried downward with the sagging breast tissue, often ending up pointing toward the floor. The breast appears to have two distinct bulges — the implant above and the sagging tissue below — separated by a visible ridge or step deformity. It is an appearance that worsens progressively over time as the ptosis increases.

Waterfall deformity does not resolve without surgery. The fundamental mismatch between an implant held high by the muscle and breast tissue that continues to descend independently can only be corrected by addressing both components: converting the implant pocket and performing a formal breast lift to reunite the implant and the breast tissue in the correct position.

The Revision Surgery: A Step-by-Step Reconstruction

Farah's breast revision was a multi-step surgical reconstruction performed methodically and in sequence. Dr. CBS began by removing both old implants and performing a complete capsulectomy — removing the entire scar capsule that had formed around each implant. With the old pocket fully deconstructed, the anatomy could be properly assessed and the correction planned precisely.

The next critical step was repairing the pectoral muscle. When a submuscular implant is placed, the lower attachments of the pectoralis major muscle are partially released to create the pocket. When converting from submuscular to over-the-muscle placement, these released muscle fibres must be repaired and re-attached to their original origin on the chest wall. Dr. CBS sutured the pectoralis muscle back to its anatomical insertion point — restoring the normal muscle anatomy, eliminating the animation deformity that comes with submuscular implants (where the breast moves unnaturally during chest muscle contraction), and closing off the old submuscular space so it cannot refill.

With the muscle repaired and the old pocket eliminated, a new implant pocket was created above the muscle — in the subglandular plane. New, appropriately sized implants were placed into this new, clean pocket above the pectoral muscle. Finally, a formal breast lift was performed: the excess breast skin was removed, the breast envelope was reshaped and tightened around the new implant position, and the nipple-areola complex was elevated to the correct anatomical height relative to the new breast mound.

Volume Reduction: Why Smaller, Perkier Implants Were the Right Choice

A key decision in Farah's revision was to reduce the overall implant volume compared to her previous implants. This is a counter-intuitive but often correct choice in complex breast revision surgery. Larger, heavier implants place greater downward tension on the lower pole skin and breast tissue — contributing to the very sagging and waterfall effect that Farah had experienced. By selecting smaller, lighter implants for the new over-the-muscle pocket, Dr. CBS reduced the gravitational forces acting on the lower pole, making the result more stable and durable over the long term.

The result of volume reduction combined with the breast lift is a breast that is smaller, higher, firmer, and more proportionate — a perky, natural-looking breast that sits correctly on the chest wall rather than a heavy, sagging breast stretched by oversized implants. Many patients who have experienced complications from large submuscular implants find that the revised result with a smaller implant in the correct pocket is significantly more satisfying than the original surgery ever was.

Tummy Tuck: Completing the Body Transformation

Alongside the breast revision, Farah underwent a tummy tuck (abdominoplasty) to address the excess abdominal skin and muscle laxity that had accumulated over time. The tummy tuck removed the excess, stretched skin of the lower abdomen, tightened the separated abdominal muscles along the midline, and created a dramatically flatter, firmer abdominal contour. Simultaneous liposuction to the flanks and waist ensured that the entire trunk was sculpted comprehensively in a single session rather than addressing the abdomen in isolation.

Combining the breast revision with the tummy tuck as part of a mommy makeover allowed Farah to complete her full body transformation in one anaesthetic and one recovery — avoiding the disruption and additional risk of a third separate surgical session for the abdominal work alone.

A Two-Surgery Total Transformation: Face and Body

What makes Farah's case particularly remarkable is the breadth of her overall transformation across two surgical sessions. Six months prior, Dr. CBS addressed her face comprehensively: the deep plane facelift and neck lift repositioned the deep facial structures and eliminated jowling and neck laxity; the brow lift restored the position of the lateral brow and opened the upper face; and the blepharoplasty refreshed both the upper and lower eyelids. Six months later, with her facial result fully settled and her recovery complete, she returned for her body surgery.

This staged approach — face first, body second, six months apart — is a thoughtful and well-planned strategy for patients who want both facial and body rejuvenation. Separating the surgeries into two sessions reduces the total duration of anaesthesia for each individual procedure, allows the patient to recover fully between sessions, and means the patient can assess and enjoy her facial result before embarking on the body surgery. Farah's decision to return to Dr. CBS for her second surgery is one of the strongest possible endorsements of both the results and the experience — a returning patient is a satisfied patient.

Results at 6 Days: Early Signs of a Major Correction

These before and after photos were taken 6 days after surgery — the earliest of the early post-operative period. At 6 days, the breasts and abdomen are still significantly swollen, compression garments are worn at all times, and the final result is far from visible. Nevertheless, the structural correction that has been achieved is already apparent: the waterfall deformity is gone, both breasts sit symmetrically on the chest wall with the nipple at the correct height, and the abdominal contour is dramatically flatter than before surgery.

Full results from this level of combined surgery take 4 to 6 months to fully establish. The breast implants will drop and soften over 3 to 4 months, all swelling will resolve, and the mastopexy and tummy tuck scars will begin their long maturation process over 12 to 18 months. What Farah sees at 6 days is the beginning — not the end — of her transformation.

Why Returning Patients Choose Dr. CBS Again

Farah's decision to return to Istanbul and to Dr. CBS for her second surgery speaks to something that goes beyond surgical technique alone — it reflects the entire experience: the quality of care, the trust built during the consultation and first surgery, the satisfaction with the facial result, and the confidence that the same standard would be applied to her body surgery.

For patients considering major plastic surgery in Istanbul — whether a single procedure or a comprehensive transformation across multiple sessions — the confidence to return for a second surgery is the ultimate measure of a surgeon's work.

Dr. Cem Berkay Sinaci is a European and Turkish board-certified plastic surgeon, Fellow of the European Board of Plastic Reconstructive and Aesthetic Surgery (EBOPRAS), and member of ISAPS and ASPS. He performs the full range of facial rejuvenation — deep plane facelift, brow lift, blepharoplasty — and body procedures — mommy makeover, breast lift with implants, breast revision, and tummy tuck — with the same standard of planning, technique, and care. If you are considering any plastic surgery procedure in Istanbul, contact Dr. CBS to arrange a consultation.