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Many women develop a bulge or lump in the armpit area, which may be more apparent in some clothing, during pregnancy or around the time of menstruation. Most people think it's because of fat or an enlarged lymph node. In most instances, it is neither. It is a common developmental condition and tissue that will not go away without some treatment and is not caused by exercise or weight loss.
This page provides an explanation of what axillary breast tissue is what causes it to form, when surgery is appropriate and what the surgery entails.
In early fetal development, breast tissue develops in two rows on either side of the body from the armpit to the groin. In normal individuals all this tissue is regressed prior to birth, with the exception of the two areas of the breast on the chest. Some individuals have left over remnants. If this remnant of tissue lingers in the underarm area, it's known as axillary breast tissue or accessory breast tissue.
Polymastia refers to the presence of glandular breast tissue and polythelia refers to a nipple or nipple-like structure only, without glandular tissue present. Many women will have axillary breast tissue which they are not aware of until stimulated to grow by hormones, typically at puberty, during pregnancy or when breastfeeding.
It is hereditary. Your risk of getting it is increased if your mother or a sister has it.
Not everyone will experience symptoms from the axillary breast tissue. If it does, the most frequently reported issues are:
Most women come in for treatment for cosmetic reasons. The 2nd is the physical discomfort. These are valid options to think about surgery.
In most cases, breast tissue in the armpit area is not cancerous. It also has the same, small risk of becoming a fibro adenoma, cyst or breast cancer, however, due to its breast tissue nature. The risk for malignancy in accessory breast tissue is estimated to be 0.2% to 0.6%. Therefore, any lump in the armpit that is hard, has a fixed shape, is rapidly growing, or has skin changes requires evaluation prior to being considered axillary breast tissue. Your surgeon will probably order an ultrasound or a mammogram to confirm the diagnosis and exclude other possible causes.
The amount of fatty tissue in the armpit area will decrease a bit after a substantial loss of weight, but the amount of glandular tissue will not decrease. That's why exercise for the chest doesn't get rid of normal breast tissue either. Removal of glandular tissue can only be accomplished with surgery once glandular tissue has been developed.
The right surgical procedure will depend upon a combination of fatty tissue, glandular tissue or a mixture of both.
If imaging shows no significant glandular component, and it is mainly fatty and soft, then liposuction alone will be performed. A small cannula is put into a 3 to 4 mm crease in the armpit, and the fat is sucked out. The ability to contour in a small area such as an axilla with VASER liposuction is attributed to its capacity to soften fat with the ultrasound energy prior to removal.
When the mass is mainly composed of glandular tissue, surgical removal is the only treatment. A cut is cut in the natural crease of the armpit, with the tissue removed directly under vision and the cut closed. The scar is hidden by the arm in the axillary fold.
If both glandular and fatty tissue is present, then it's the most common scenario, and that's when Axillaplasty (combined excision and liposuction) is performed. The part of the gland that contains the fat is removed and the fat itself is sucked out. This provides the best and permanent result.
The procedure is done under general or local anesthesia with sedation. This will take about 60-90 minutes. The vast majority of patients are discharged on the same day.
This area of the armpit is tender and swollen for the first week. A compression garment is used for 4-6 weeks to allow for even retraction of the skin. Most patients are back to desk work within 5-7 days and are back to full physical activity (including arm exercise) 4 weeks after surgery.
The skin around the axilla may be slightly loose for four to six weeks following surgery, and then tighten down to a more natural shape. The incision is in the natural fold of the skin in the armpit, resulting in very little scarring.
After all glandular tissue has been removed the glandular tissue does not regenerate. The result is permanent. If there is substantial weight gain, the fatty tissue can grow back again, hence the best way to achieve and sustain the results is to maintain a stable weight after surgery.
Dr. Anup Dhir, Senior Consultant Plastic and Cosmetic Surgery at Indraprastha Apollo Hospital, New Delhi has a vast experience in both axillary breast tissue removal by excision as well as VASER liposuction for breast and body contouring procedure. An ultrasound is performed prior to any surgery to analyze tissue content and to help direct the surgical procedure.
Leave a request to connect to Dr. Anup Dhir for an Appointment.