This is a common problem with women who have breast reduction surgery, as there is an extension of breast tissue in the axilla called the tail of spence. The breast is largely replaced by fat as one gets older, so does the fat in the tail of spence. Insurance will not pay for the liposuction of this tail of spence.
As part of the surgery, I will frequently do liposuction of this area, otherwise the patient complains that the breast is wide and flat. This lipo of the axilla can easily be done through the outer incision, and you usually get 300 to 500 cc's of fat from each side. This helps form the breast and define the breast so that it is not so flat and wide. Patients really appreciate this contouring.
If there is also extra skin, that must be removed by extending the incision into the armpit. Unfortunately, extending the incision makes it easier to see the scar in a bathing suite, but you have to do what is dictated by the diagnosis. Thankfully this is not needed as much if you just do the lipo to the axillary tail of spence.
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