Breast Lumpectomy Axillary Tail Removal with Breast Augmentation?

I went to a surgeon to ask about fatty under arms. I was told by my OB it was breast tissue. Its very large and has to be tucked into my bra which makes it painful by the end of the day. I was told I would need a breast lumpectomy axillary tail removal. Since I have to have a surgery to begin with, could I have Breast implants done at the same time thru the arm pit since I will be in surgery and need drains there anyway?

Doctor Answers 10

Treatment of lateral breast fat pad ("chicken nuggets")

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In most instances, that in fact is not breast tissue but a discreet fatty pocket (aka "chicken nuggets" by many women). This has been described a number of times in the anatomy literature, and calling that tissue "accessory breast" tissue is just incorrect most of the time.

That cosmetic procedure to remove or liposuction that tissue can certainly be done simultaneous to implants, but I do not use that same incision as it is an unfavorable approach for a precise disection for a breast augmentation

Breast augmentation at the time of removal of axillary breast tissue

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I would not recommend placing breast implants at the same time and thru the same incision used for removal of axillary breast tissue. Your risk of complications may be increased from combining the procedures. I would recommend dealing with your axillary symptoms first. A consultation can more clearly define the best options for you. In general these options may include weight loss, different bra, liposuction of the area, or direct excision of the axillary breast tissue and some overlying skin.

John E. Gross, MD
Los Angeles Plastic Surgeon

Is your weight optimized

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It appears that you might be somewhat obese by your photos and you should optimize your weight as much as possible prior to contemplating surgery. If it is optimized, then in is certainly possible to do an augmentation as the same time. Whether you need a real lumpectomy of breast tissue or merely liposuction of excess fat in the axillary tail can only be judged by examination.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Axillary breast tissue can be removed directly, or with liposuction

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Patients often feel that they have excess fat under the arm, or actually just below which is difficult to conceal as it tends to push up from under the bra. This excess is breast tissue which we often describe as ectopic, or developed outside of the normal area of breast development. Axillary breast tissue is fairly common, and we see it more often associated with a very large breast. When confronted with excess axillary breast tissue during a breast reduction it is fairly simple to remove and reduce the tissue by direct removal, or by using liposuction. The tissue is fibrous and we most often rely on ultrasound for removal.
Average sized breasts may have axillary breast tissue as well and do quite well with ultrasonic liposuction. As a caution however, the fullness and skin excess can vary. Some individuals may have so much skin excess associated with the axillary breast that skin removal may be necessary as well. This should be found out during a good office examination.
Concerning breast augmentation, I think it reasonable to consider transaxillary augmentation at the same time, though others may disagree. It is worth exploring this option with your surgeon.
Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

I would suggest separating the surgery

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Doing an axillary tail excision with drain placement would be, in my opinion, a contraindication to breast augmentation at the same time. You may have some lymphatic drainage that lasts more than a few days and your surgeon risks contaminating the pocket that the implant will be in. I would suggest waiting on the breast augmentation, but it would be best to get an opinion from a doctor who can examine you in person.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Procedures Should Be Staged-- Safety Should Be Top Priority

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Your history and pictures suggest the presence of axillary breast tissue. Axillary breast tissue not only creates a cosmetic deformity, but can cause significant discomfort as well. For this reason, it’s not unusual for patients to request removal of this extra tissue.
The axilla is a unique anatomic area with a large number of lymphatic channels.For this reason it’s not unusual for patients to develop seromas and prolonged drainage. This fluid can ocassionally become secondarily infected.
For this reason, we generally recommend that axillary tissue removal and breast augmentation be staged. Infection in the presence of breast implants could have significant consequences.Although it’s possible to perform these operations together, safety should be everyone’s first priority.
If you’re considering removal of axillary breast tissue and breast augmentation, it’s important to consult a board certified plastic surgeon.This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and aesthetic goals.

Axillary breast tissue

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Thank you for your question and your photo...hope that these answers will assist in your decision.  It does appear that you do have some excess tissue on the axillary area/axillary tail breast tissue.  First off, I would get a clinical exam and mammogram prior to considering any breast/tissue excision.  Removal of this tissue usually requires excision of the tissue along with excess skin.  I am not sure if straight liposuction would give the results that you are looking for in your case.  Drains are usually required as drainage from the area is typical for a lengthy period.  That being said, I would advise not to consider breast augmentation at the same time, but would separate the two procedures as the chance for complications, most worrisome of which is infection, would certainly be much higher with a procedure such as the above in combination.  Good luck with your decision!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast tissue under arm

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I would not have an augmentation at the time of removal of this breast tissue. It sounds termpting to do together but, in my opinion not advisable. After the tissue resection, I usually need to remove skin and there is a need for a drain to be placed. The drain may seed bacteria which could affect your implants.

Breast lumpectomy axillary tail removal with breast augmentation

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Dear Madness113,
You do appear to have an enlarged axillary tail.
Several considerations are in order. Your bra appears to be digging in so I am not sure if this MAY be related to your being slightly over weight or wearing an ill fitting bra. (Before you protest, please, be aware that a HUGE number of women were never fitted properly for a bra and go around wearing bras that do not fit them.)
While liposuction of this area may be done, it usually deflates the area but leaves an empty sock looking skin fold so a true excision is preferable despite the scar.
While both an augmentation and axillary breast removal COULD be done together, you MAY be taking on a higher risk of complications. Primarily, prolonged swelling of the breasts due to interference with lymphatic flow from the breast through the area of the axillary tails. Another consideration may be the idea that as the lymphatic flow may be interfered with, it is done at a time foreign bodies, the implants, are placed, which require the body to be able to fight infection of the implants from the moment the implants are placed in you.
Therefore, if you "want to play it safe" you may want to do the procedures one after the other.
I hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Axillary breast tissue removal

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I would suggest having the axillary breast tissue removed first , and then coming back at a later time to have the formal breast augmentation performed.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.