Hello and thank you for your excellent question. Depending on the technique used, it is absolutely possible to remove axillary fat at the same time as a breast reduction. If you are planning on having a breast reduction, you should be evaluated for a No-Vertical-Scar breast reduction. There are a number of no-vertical scar breast reduction techniques, but my preferred technique is the Bellesoma Breast Reduction technique. In my professional opinion, this technique represents a “quantum leap” in breast lift techniques. Our technique provides an exceptional breast lift, upper pole fullness, relief from neck and back pain, and no vertical breast lift scar. It uses a woman’s OWN breast tissue to produce an internal suspension technique and breast augmentation, without the need for a breast implant. It does not disturb the nipple, areola, or breast glands, so sensation and the ability to lactate is preserved. It uses 3D scanning of your breasts and body to design a procedure specifically designed for YOU, and you alone. Finally, for patients who desire breast enlargement, the constriction of breast width can result in an increase in cup size, and it can be combined with fat grafting to increase breast size. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate you. Preoperative visualization with Crisalix can simulate what your body will look like after surgery and can help you make your decision. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. Good luck!