1 yr post op, will weight loss aid in fat reduction of the under arm area or will this need to be surgically removed? (photos)

Question

1 yr post op, how do I deal with the fat under my arms? Would weight loss solve this or would surgery be the only way to deal None

Semih Yildiz, MD, FEPOBRAS · Answer

Weight loss can help if the underarm fullness is mostly general subcutaneous fat and you are still above your stable goal weight. It will not reliably correct loose skin, axillary breast tissue, or a defined fold that remains after surgery. In the visible photos, there appears to be fullness and folding along the lateral chest/underarm area, but an exam is needed to tell how much is fat, skin laxity, or breast/axillary tissue.

At 1 year post-op, most swelling has settled, so it is reasonable to have this assessed if the area still bothers you. If the issue is mainly fat and the skin has good tone, targeted liposuction may help. If there is loose skin or firm axillary breast tissue, direct excision or a scar extension may be more effective than liposuction alone. It is best to be near a stable weight before revision planning, because further weight loss can change both the fullness and the amount of skin laxity.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding if weight loss will aid in the fat reduction of the underarm area or if it will need to be surgically removed. Unfortunately, I do not think further weight loss will reduce this area of skin and fat; I think it needs to be surgically removed. You may have loose skin in this area if you have liposuction. Therefore, I would suggest an incision be placed around this area of excess skin and fat, and the excess skin and fat be directly excised. It may be possible that this area can be done in the office under local anesthesia. However, weight loss will not solve this problem. I hope this helps to answer your question.

Zoran Potparic, MD · Answer

Liposuction sholud be the first option. However, if skin is not expected to retrsct (this can be evaluated only in person), direct excision of the role may be necessary. Good luck.

Daniel Barrett, MD · Answer

Dear Bgt86,
it is hard to tell for sure without an examination. Based on your photos, it looks like weight loss won't help with this issue. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

The area that concerns you needs to be examined to determine if it is excess fat, skin laxity or a combination.  It is likely a combination in which case surgical removal would give the most predictable result.  If it is just excess fat then localized liposuction should improve it.

Douglas Taranow, DO, FACOS · Answer

What you have is excess skin of the anterior axilla (most commonly from weight loss).  This area is not amenable to liposuction, but rather skin excision.  The challenge here is that the scar is visible as it must run superiorly above the fold and down into the armpit.  If too much skin is excised, the ability to raise your arm above your head is limited or the wound dehisces (opens up).  
Best wishes.
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

It would be very helpful if you would’ve included before and after pictures and give us more history about your procedure.
Based on your scars I’m assuming you had a gynecomastia surgery with skin tightening which by the way looks like it was done exceptionally well.
It is not an easy procedure to do and end up with a natural looking chest which you have despite the scar.
The armpit issue looks like it is purely skin laxity and requires a second skin excision. it could potentially be done as an office based procedure using local anesthesia or in an operating room with sedation or anesthesia. 
Talk to your plastic surgeon about having this skin exercised as well.
I suppose it would’ve been ideal to address that during your initial consultation before you had your chest procedure.
Always include before and after pictures when getting a second opinion.
If you don’t have before and after pictures then ask your surgeon to forward the ones they took.
Best,
Mats Hagstrom MD

David E. Berman, MD (retired) · Answer

liposuction will be useless here. your problem is loose skin.
however, if you notice when you extend your arms fully above your head, then all of the loose skin will disappear. the problem is that if the surgeon removes this extra skin when. your arm is at your side, when you raise your arm above your head, you will either rip open the incision, or you will not be able to fully extend your arm. both very problematic.

david berman md, frcsc

1 yr post op, will weight loss aid in fat reduction of the under arm area or will this need to be surgically removed? (photos)

Answers (8)

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