Remove Fat and Loose Skin Under Arms

In my practice we refer to your condition as "axillary puffs."  For optimal results I remove an ellipse of skin in addition to the deeper tissue, which typically contains fat and breast tissue.  I hide the incision where the armpit hair is located and it heals very well. It is a great option for you.

Thank you for your question and photo.  Your expectations will dictate the best procedure(s) for you.  I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals.  Best of luck!
Dr Dhaval Patel
Double Board Certified
Plastic Surgeon
Chicago
Hoffman Estates 
Oakbrook 
Orland Park

This excess tissue may be associated with the tail of the breast. However it also may just be loose excess adipose tissue that has accumulated in the pre-axillary region. In either case while liposuction may improve the volumetric discrepancy it will not address the loose skin and therefore a very potentially unfavorable postoperative scenario of loose and redundant skin may have undesirable results. With any area of excess tissue and fat a skin excision to remove both will help with the contours. Certainly having another scar in this area is less desirable however with good scar massage and silicone treatment and postoperative care in addition to fastidious surgical technique the scar patterns can be very minimal. Look for a surgeon who has an expertise in doing brachioplasty's as well as breast reduction surgery to help you with this very complex area

It would be best to meet with a board certified plastic surgeon to allow them to examine exactly what kind of tissue is under your arm there. As other surgeons have mentioned here, it could be breast tissue, it could be fat, there will likely be skin that also needs to be addressed depending on your desired result.

Thank you for your question.  The armpit aka axilla is a common location for accessory breast tissue.  This is known as the tail of spence.  Liposuction is a very common treatment modality for removing the excess tissue, however, just as in other areas of the body that are liposuctioned, it does not treat the overlying skin.  What I mean by this is if the tissue is removed by liposuction but the overlying skin has lost its elasticity, it will not contract back to a flat/normal contour.  After a full examination, if it is determined that all the tissue has been previously removed and what is left is excess skin, then this will need to be surgically removed.  This is usually performed through an ellipse that is placed within the natural hair-bearing portion of the axilla to hide the scar.  Hope this helps!

Unfortunately, your situation is not surprising. In your case, liposuction alone does not always solve the problem. You are left with a significant amount of loose skin and some residual tissue – likely breast tissue and fat. Your best option is a direct surgical excision of the tissue. This may be done as an ellipse of skin and  deeper tissue with a crescent shape incision hidden in the armpit, or a linear incision from the top of the arm extending down to the chest wall. The optimal  approach depends on the amount of loose skin you have  in the armpit and surrounding areas. This is a procedure that can give you a very good result and has a very, very high satisfaction rate. Patients are very unhappy when they have this excess skin and are delighted after its removal. It's critical that you seek the advice of a surgeon who has extensive experience in body contouring and is certified by the American Board of plastic surgery. I wish you the best, Dr. Gabbay

Thank you for your question.  It's not uncommon to have some excess breast tissue in the armpit.  Anatomically, this area is called the Tail of Spence, an extension of breast tissue toward the armpit.  This could also be considered accessory breast tissue, and if there is discomfort, then this may be covered by insurance.Liposuction alone does not work on areas were there is a component of excess skin.  This is even true for liposuction technologies that claim a significant tightening of the skin: it just isn't enough.  Excess skin, with or without excess fat and/or breast tissue has to be removed by excision.  The procedure is design to minimized the the appearance of the scars by laying the final closure in natural creases or under clothing areas.  In your case, I would design a crescent shaped excision of the skin to encompass the entire area of excess breast tissue and have the closure within the armpit.  The scars should be quite inconspicuous. 

I have quite a few patients that come in and complain of this extra arm pit fat and skin. In some people, I believe liposuction can help but in many people I believe excising it is really the best option. There are pros and cons to everything and with excision all that extra tissue will be gone but you will be left with a line as a scar. Many patients would much rather have a scar than all that extra tissue hanging down, rubbing against them and being unsightly both in and out of clothes! The incision usually heals very well. The best way to answer your question is to be evaluated by a board certified plastic surgeon. Go to a couple of consultations and get different opinions, ask a lot of questions and then make your own decision on who you think gave you the best advice. I hope this helps, good luck with your journey and I hope your are able to get this taken care of soon!Ankur Mehta MD

Thank you for your question regarding excess skin and fat of your armpit. It appears from your pictures that you have excess skin and fat of the armpit or axillary region. This is common after weight loss. In addition, this can happen after liposuction. Typically, this excess armpit skin and fat hangs over the bra strap and can cause chaffing. The surgical treatment is removal of excess axillary or armpit skin and fat. An incision is made vertically from the armpit down toward to the top of the bra. I call this a vertical torsoplasty. The procedure is performed under general anesthesia and takes about 1-2 hours for both sides. After the procedure, most patients go home.
Like most plastic surgery procedures, the price of this procedure depends on geographic location, surgeon experience, cost of the operating room, and the anesthesiologist’s fee. Please consult with several board certified plastic surgeons to get idea of the price ranges. Fees can vary widely.
Good luck with your vertical torsoplasty. If you have any questions, please do not hesitate to contact my office.
Sincerely, Dr. Katzen

Thank you for your question and sharing your photo.  I would recommend visiting a board certified plastic surgeon to discuss a direct excision of this tissue.  This would provide the best solution as you also have some excess skin in that region that can be removed.

I recommend resection of the extra skin, fat and gland from under your axilla. This involves special cuts to avoid any limitation of movement of your arms.