The thing that you have to realize about "fat" under each arm pit is that it is not all fat. Some of that can certainly be fat. However, a lot of the time, some of the "fat" is actually breast tissue. This is where a physical examination is needed. If it is mostly fat, you can get good improvement with liposuction. If there is a lot of breast tissue, it will need to be surgically removed. In this case, some skin can be removed as well to help improve the contour.
Thank you for the question. It would behoove you to be examined in person by a well experienced board-certified plastic surgeon. This examination will be critical in determining the best course of action. For example, if the area consists of “fat” then liposuction may be an option depending on the skin elasticity overlying the area). If the skin elasticity is not sufficient then direct excision of skin and underlying adipose tissue may be necessary. If the area of concern, on the other hand, consists of breast ( axillary tail of Spence) that liposuction will likely not be effective and direct excision of the breast tissue and overlying skin will likely be necessary to achieve the desired results. Again, examination by well experienced board-certified plastic surgeon is indicated. I hope this helps.