Is it necessary to have my tail of spence removed? With that being said, will it compliment my BA surgery at all??

Thank you for this very important question.  Since breast augmentations are a want and not a need, no portion of a breast augmentation "needs" to be done.That being said, the Tail of Spence is that nasty bit of fat at the front of many women's armpit which is a remnant of the breast tissue that came in during puberty.  This small piece of breast tissue at the anterior aspect of the armpit normally turns to fat within a few years (around age 15).  This fat, not being part of the diet and exercise pool, cannot be gotten rid of by exercising or any dietary change.  Since breast augmentation is an aesthetic (cosmetic) procedure, and in my experience most, if not all women who have this fatty tissue think it is unattractive and wish they could get rid of it.  Since liposuction of this area can be done through the same incision that one does a transaxillary breast augmentation through, this area can be suctioned out quickly, and almost effortlessly.  Sadly, I had a patient years ago who died from breast cancer originating in the Tail of Spence.  Although few, if any breast cells, can be removed by liposuction, if the surgeon sucks away the fat surrounding these breast cells, it becomes quite easy to visualize and/or palpate any cancerous changes in the residual breast cells.If you were my patient, I would liposuction the Tail of Spence at the beginning of a breast augmentation for both aesthetic and health reasons, and I do not charge anything extra for this procedure since it is so quick and simple.  Going back to your original question, is it necessary to get rid of the Tail of Spence in a breast augmentation, I think the breast augmentation is not necessary.  (It's a want, not a need.)  But honestly, removal of the Tail of Spence may be the most necessary part of this procedure.  Secondly, you ask will it compliment my breast augmentation.  From an aesthetic point of view, it's removal certainly makes a breast augmentation more attractive.

Dear Ceedee808,The Tail of Spence is a normal collection of breast tissue and fat in the armpit region.  Most women will have some extension of their breast into the armpit region.  There really is no increased health risk to you if you have this.  Cancer occurring in this breast tissue could theoretically happen, but it is extremely rare and in my experience, I have not heard of this.  It is unnecessary to remove breast tissue in the armpit, unless it is significant.  In most women, a mild fullness in the armpit region becomes minimized when the breast is enlarged.  This is the case in most of my patients.  If you have significant fullness in this area that would still be apparent after your augmentation, removal could benefit your outcome, but this is uncommon in my practice.  Removal could be accomplished with liposuction alone if the fullness in your armpit is comprised of only fat.  Breasts are comprised of fat and breast tissue, which is the glandular tissue that produces breast milk.  Glandular tissue is firm and hard and cannot be removed by liposuction.  If there is a significant amount of breast tissue in this area, liposuction cannot remove breast tissue and it would need to be removed directly by the surgeon by dissection from the surrounding skin and muscle.Aloha,Shim Ching, MD

Thank you for your question. You do not need to have the tail of spence removed. You may want to remove the fat, speak with your surgeon regarding the benefits of you having it removed. Best,