Axillary breast tissue - Axilla lipo vs. excision. Which procedure is needed? (Photo)

Question

I have axillary breast tissue under one arm, already determined to be benign. It hurts though, and I want it removed, but I'm concerned about long-term pain and scarring. I've read that this procedure can sometimes be done with lipo but other times requires excision; how do you determine which procedure is needed? And what can I expect in terms of cost and recovery?

Semih Yildiz, MD, FEPOBRAS · Answer

Whether liposuction or excision is best depends on what the tissue is made of. I reviewed the photo; the visible issue is a localized axillary/lateral chest fullness, and an in-person exam is needed to tell how much is soft fat, glandular breast tissue, fibrous tissue, or loose skin.
Liposuction can work well when the area is mostly soft fatty tissue and the skin is expected to contract. Excision is usually more reliable when there is firm accessory breast tissue, a defined lump of glandular tissue, or excess skin that would remain after lipo. Sometimes a combination gives the best contour.
Scars are usually placed in or near the axillary crease when excision is needed, but any incision can leave a visible scar or cause temporary numbness, tightness, or tenderness. Recovery is often a few days to a week for light activity, with swelling and arm soreness improving over several weeks. Cost varies widely with surgeon, facility, anesthesia, and whether pathology is needed.

Ashraf Abolfotooh Khalil, MD · Answer

Thank you for your question and for providing an image.
For axillary breast tissue, the procedure depends mainly on the amount of tissue and whether there is excess skin.Liposuction only works if it is mostly fatty tissue and if it can be removed without leaving extra skin behind.Excision is required if there is excess skin, and the scar is usually placed under the armpit where it is well hidden.Recovery depends on the procedure, but generally, most patients can expect the main recovery period to be about 2–3 weeks.Cost and final procedure choice can only be determined after an in-person consultation with a board-certified plastic surgeon who can examine your case and recommend the safest and most effective approach.

George Marosan, MD · Answer

Thank you for your question and photo. Axillary breast fullness is rarely just fat. It is a combination of fat plus breast tissue. My approach would be liposuction the fat and then excise the breast tissue via an incision in the armpit. Some skin excision might be beneficial in your case. This can be done under local tumescent anesthesia +/- IV sedation. See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Maryam Zamani (Saheb-Al-Zamani), MD · Answer

Hi,
Axillary breast tissue can be treated by either excision or liposuction (+/- Skin tightening). The optimal treatment choice depends on the quality of the tissue in the axillary area, as well as the skin excess and quality (the skin's ability to contract with skin tightening as opposed to skin removal). A consultation is required for full assessment and a personalized treatment plan.
Best, 
Dr. Maryam Zamani MD FRCSC 
Double-Board Certified Plastic Surgeon

Camille Cash, MD · Answer

This excess tissue can be addressed by either excising (surgically cutting) it or suctioning it.  There are a few considerations to determine what is best.  First of all the nature of the tissue must be evaluated.  If it is mostly fatty in nature then liposuction can be used to decrease the volume.  If it is more fibrous in nature than excision may be indicated.  Also the size.  Obviously liposuction leaves very tiny scars, where excision would be greater.  However if the suctioning alone would leave loose, hanging skin then excision may be the better option.  Begin by visiting with a board certified plastic surgeon near you for an evaluation to learn more.

Axillary breast tissue - Axilla lipo vs. excision. Which procedure is needed? (Photo)

Answers (5)

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