Male with fat on the side of chest/just under armpits. What can be done?

Question

I'm an 39yo male and my body seems to really want to store fat just off the side of my chest. It's tough to describe the area -- it's not my pec, it's not gynecomastia. It's not the arm. It's not right in the arm pit either. When I see pictures of "bra bulge" in women, though, it kind of looks like what I have. My problem is that it will not go away, despite pretty intense exercise and calorie reduction. And it makes it *impossible* for me to find a shirt that fits. What can be done?

Alan Gonzalez, MD, FACS · Answer

Thank you very much for your question, I suggest to you is a body contour liposculpture to be able to define the anatomical shape and have a natural resultIt would be ideal if you could see some photographs to be able to guide you and suggest a personalized planLiposuctionThe surgical procedure of liposculpture,may or may not be associated with technology. Many times the characteristics of these lumps under the skin or retractions are secondary to a conventional fat extraction technique. We handle fat from the use of laser technology, which is light, or vaser, which is internal ultrasound associated with microair (PAL- Power ssisted liposuction) the first two devices allow us to vase or Laser produce lipolysis (is to pass the fat of a solid state to a liquid state so that there are no irregularities under the skin) and the microaire or the PAL allows us to make the extraction of the melted liquid without so much trauma.The problem in your case, is that not only has the sequelae of the lipo, but besides, I think you can have a little diastasis of the abdominal muscles secondary to pregnancy.It is important to be able to evaluate the case a little more to determine if only with a new lipolysis from the combination of technology can be improved. If it is only a lipolysis of the body contour, we will be able to improve the appearance by 50% towards 70% of the result you currently has; because fibrosis behaves as a scar inside the tissue and it is very difficult to be able to remove it completely. Associated with that if the skin is flaccid in order to give a little more reaffirmation, we complement it with a technology called Jplasma, the equipment is known as Renuvion, this produces plasma energy and this produces collagen retraction working inside the tissue The liposculpture that we practice is always associated with technology. What we use is Vaser, that is, internal ultrasound, laser, which is something from the light that is produced from the breakdown of fat, these two equipment fundamentally to produce lipolysis that is to pass fat from a solid-state to a liquid state This allows us to maintain that patients are not left with fibrosis or irregularities under the skin. As a complement always use microaire for the extraction of fat that is liquid, and in the final part if it is the case that the patient requires because it presents sagging skin in determinate areas, arms, back, abdomen, etc we use Jplasma, which is a specific equipment to produce
Liposuction with technologies
For the back, the ideal would be definitely to do an lipolysis associated between vaser and microaire combined with j-plasma to produce skin retraction (it is a tension inside the skin), and finally also a back lift, leaving a scar for remove excess of the skin that is left over. The reduction of fat through high-tech equipment and skin reaffirmation, will give us the best result; a toned skin and a scar that must be left in order to remove the skin that is left over

William Groff, DO · Answer

Liposculpture is a procedure designed to remove stubborn fat from nearly any area of the body. I use micro-cannulas for this procedure that result in less damage to surrounding tissue and a shorter recovery time in most cases. The procedure can also be performed using local anesthesia. I advise you to find a board-certified physician with expertise in this procedure to ensure the best possible result.

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. To provide a valid medical opinion I will need to see pictures of you body from different angles. I would suggest to be treated by board certified plastic surgeon with experience in this procedure, to get the best desired results.
Respectfully,Dr. Emmanuel Mallol Cotes.-

Miguel Delgado, MD · Answer

It is hard to give an opinion without any pictures. It sounds like you may be a candidate for liposuction which is a great procedure for removing fat that is difficult to remove with diet and exercise. consult with a board certified plastic surgeon to learn what options are available to you. Good luck.

Douglas Wu, MD · Answer

Thank you for your question. While it’s difficult to give you a recommendation without at least a photo or two, I can tell you that this area can often be treated using liposuction. The procedure uses small cannulas to gently suction away stubborn fat, creating a smoother contour. In my office we use the Awake lipo technique, which can be done using local anesthetic. Recovery is usually about one week and the results can be long-lasting as long as you maintain a healthy weight. 
I encourage you to schedule a consultation with a board-certified dermatologist with expertise in body contouring. Through an in-person examination and discussion of your concerns and goals, your doctor should be able to design a treatment plan that works for you.

Alex Campbell, MD · Answer

Thanks for your question. Based on the information provided it seems like liposuction would be a good option. Best is to have a consultation with a Board Certified Plastic Surgeon with specialized expertise in this procedure.

Kimberly Butterwick, MD · Answer

While it is difficult to make a recommendation without at least a few photos, it sounds like liposuction may be a good choice for you. This minimally-invasive procedure removes isolated areas of fat that do not respond to diet and exercise. It can be used on nearly any area of the body in need of contouring, as long as it is performed by an experienced provider. I have treated the area you describe in both males and females. It’s like a pillow of fat, lower than the armpit and you can feel it when you put your arms down. In some patients, they can’t put their arms at their sides. If this describes your situation, you will do well with liposuction.
In my office, we offer the Awake liposuction technique. This approach can be done under local anesthetic and uses infusion of tumescent fluid that loosens the fat cells before removal. The treatment results in the most precise sculpting results and typically involves a shorter downtime. The fat is suctioned away via small cannulas inserted through tiny incisions that don’t require suturing and leave little or no scarring behind. Since the fat is completely eliminated, the results are very long-lasting. Make sure you work with a board-certified dermatologist with extensive experience in liposuction to ensure your treatment is both safe and successful. If the problem is small, your doctor may even be able to use CoolSculpting to reduce the area. Make an appointment for evaluation and find out what is best for you.

Mitchel Goldman, MD · Answer

While it’s difficult to make a full assessment without seeing you in my office, it sounds like you might be a good candidate for liposuction of the area. I use the Awake lipo technique, which can be performed using local anesthetic and is less invasive than traditional liposuction. The incisions used to perform this treatment are too small to require sutures and do not leave much visible scarring behind. The fat is removed from the body for long-lasting results. Make sure you work with an experienced doctor who is board certified to ensure an optimal outcome.

Kenneth Hughes, MD · Answer

BodyTite does not remove any fat, but it is capable of producing a 45% contraction in tissues.  It can be combined with liposuction to improve contours dramatically.  Bruising and swelling can occur post-op.  Results can be seen immediately after one treatment and are more evident over three to six months post-treatment. Wait until six months to fully evaluate the aesthetic results.  Sedentary activities can be resumed in two to three days and full activity with exercise within two to three weeks.

Jason Emer, MD · Answer

You need a formal evaluation by an expert in body shaping and contouring to determine what is best. Traditional liposuction awake and smart liposuction are old methods that do very poorly for tightening skin or or contouring. Small problem areas can be improved slightly by these methods. The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. Overall, you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. See an expert. Best, Dr. Emer.