Can I get painful axillary breast tissue removed? (Photo)

Question

I have axillary breast tissue on both sides and am desperate to get it removed. My insurance will cover the procedure if I prove that it’s medically necessary. I have documentation from the past 4 years seeing different doctors to try to resolve the pain, its not just during my menstrual cycle but at all times. I live in the Las Vegas area and am hoping to find a surgeon in this area willing to work with me to get the pre certification from insurance.

Gary M. Horndeski, MD · Answer

You
have large ptotic breasts and you would benefit from a breast reduction with
removal of the axillary tissue.  The
other alternative is direct excision over the axillary area.Best Wishes,Gary Horndeski, M.D.

Robert Oliver Jr., MD · Answer

In point of fact, it is incorrect to call that accessory breast tissue. It's not, in almost all cases this is just fatty tissue without glandular breast tissue in it. Removal of it is almost always considered a cosmetic surgery.With anatomy like yours, liposuction does poorly as a stand alone treatment. Because of the skin expansion. It will not contour right without excision of a good bit of that skin.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.  It is not uncommon for patients to present with concerns about "armpit fat".  
These areas are best treated with direct excision of skin and/or adipose and breast tissue directly in most cases.  The upside with surgery: improved contour of the are. The downside: a scar that should be kept as short as hidden as possible (in the hair bearing area of the axilla).
 Sometimes, in relatively "mild" cases liposuction surgery alone may suffice. Factors such as size of area of concern and quality of skin elasticity play an important part as to what modality of treatment would work best.
 
 My best suggestion: select your plastic surgeon carefully. Communicate your concern/goals carefully as well. Working together you will come up with a good surgical plan to achieve an outcome that you will be pleased with. Best wishes.

Karl William Schwarz, MD · Answer

Axillary breast tissue is not that uncommon and it is pretty simple to treat with an incision in the axillae with removal of the gland and also with liposuction for the surrounding areas to help blend. In my opinion, I think it is important to remove this tissue, because it is hard to screen with a mammogram and may be overlooked and is a good enough medical reason to warrant excision regardless of the issue of pain which carriers are not as likely to use as a reason for approval.

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Danielle Marie44,Hello and thank you for your excellent question. I agree with many of the comments on this thread.  You could opt for liposuction, direct excision of this tissue, or a formal breast reduction. I have found that many patients can get GOOD results with liposuction alone, and EXCELLENT results with IDEAL Liposuction! IDEAL Lipo is a proprietary technique that we have been developing for the past 12 years. First off, these procedures are typically performed in the office, with only local anesthesia (although patients can request deeper sedation, if they so desire). We typically use Smart / Laser Liposuction or VASER (ultrasound) to reduce dense, fibrous fat, and stimulate collagen formation; Radiofrequency-based skin tightening (like Body Tite, or Thermi) to maximize skin contraction; and Ultrasound, RF, or subcision (Z Wave, Venus, Cellfina) to treat cellulite. Patients go home the day of surgery; typically do not use any narcotics postop for pain control, and are back to light exercise and work 48 hours after their procedures. In my practice, we specifically evaluate patients for these additional treatments, and select the appropriate treatment based on their skin quality, amount of fat, previous treatment(s), and surgical goals. 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 for that procedure. 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. If you have any questions, call our office for assistance. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 - 2018

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