Axillary breast tissue, also known as accessory breast tissue or polymastia, is a condition where extra mammary tissue develops outside the typical breast region, most commonly in the armpit area. This tissue contains the same components as normal breast tissue and can sometimes be a source of cosmetic concern or physical discomfort.
The Development and Characteristics of Axillary Breast Tissue
Accessory breast tissue results from an anomaly during embryonic development, relating to the “milk line,” or mammary ridge, which extends from the armpit to the groin during gestation. While most of this ridge regresses, remnants can persist and develop into functional breast tissue outside the standard location.
Unlike a simple fatty deposit, or lipoma, axillary breast tissue contains true glandular components, ducts, and stromal tissue. This composition means the tissue can respond physiologically to hormonal fluctuations. This accessory tissue may swell, become tender, or experience pain during menstruation, pregnancy, or lactation, often becoming noticeable only after puberty.
True axillary breast tissue is defined by the presence of dense glandular elements, which are distinct from the soft, homogeneous appearance of mere fatty deposits. The density and structure of the mass dictate whether non-surgical or surgical approaches will be effective.
A proper diagnosis is achieved through a clinical physical examination, but imaging confirms the presence of glandular material. Healthcare providers use ultrasound or mammography to distinguish this glandular tissue from simple localized fat accumulation, sometimes referred to as pseudogynecomastia.
Evaluating Non-Surgical Management
Many individuals first explore non-invasive methods, assuming the axillary mass is simply excess body weight. General weight loss efforts, such as diet and increased physical activity, can certainly reduce the overall amount of fat present in the body, including the subcutaneous fat surrounding the accessory tissue. However, these lifestyle changes cannot eliminate the underlying dense glandular tissue that defines the condition. Because the glandular component is unaffected by calorie restriction, the mass often remains prominent even after significant weight reduction.
Targeted exercises designed to strengthen the chest or back muscles may improve posture and contour, potentially making the area appear firmer. This muscular development can subtly alter the appearance but does not physically remove the mammary tissue itself.
Some individuals find temporary cosmetic improvement by wearing supportive or compression garments. These specialized bras or tops physically flatten the area, reducing the noticeable bulge under clothing. This is a management strategy for appearance, not a permanent solution for removal.
Hormonal manipulation, such as the use of certain medications, is sometimes explored for other breast conditions but is rarely a suitable or recommended treatment for solely cosmetic removal of axillary tissue. Since the tissue is fully formed and functional, non-surgical methods remain fundamentally limited in achieving complete and permanent elimination.
Clinical Removal Procedures
When non-surgical strategies prove insufficient, clinical procedures offer the most direct and permanent solution for removing axillary breast tissue. The choice between techniques depends primarily on the tissue’s density and size, as determined during the pre-operative imaging.
Liposuction is often the preferred method when the accessory tissue is soft, relatively small, and composed predominantly of fatty and fibrous material. This minimally invasive technique involves inserting a small cannula through tiny incisions, typically hidden within the armpit crease, to suction out the excess material. Recovery from liposuction is generally quick, with most patients returning to light activities within a few days.
Direct surgical excision, however, becomes necessary when the tissue is dense, large, or contains a high proportion of glandular components. Excision allows the surgeon to physically remove the entire glandular mass, ensuring complete elimination. This technique is also preferred if there is any suspicion of atypical cells or malignancy within the tissue.
Often, surgeons employ a combination approach, using liposuction to remove the surrounding fat and then performing a limited excision to extract the central, dense glandular core. Scars from excision are carefully placed within the natural folds and creases of the axilla to minimize their visibility.
Post-procedure care for both techniques typically involves wearing a compression garment for several weeks to minimize swelling and assist the skin in conforming to the new contour. Potential complications include the accumulation of fluid (seroma), bruising, temporary numbness, and scarring. Seromas may occasionally require aspiration by a clinician to prevent discomfort and aid healing. Patients are usually advised to limit strenuous arm movements for two to four weeks following the procedure to facilitate proper healing.