The appearance of a bulge or extra tissue in the armpit area is a common concern. This tissue, often referred to as “armpit fat,” may be medically identified as axillary breast tissue or accessory breast tissue. While this phenomenon is generally benign, it can cause physical discomfort and significant cosmetic distress, particularly when wearing certain clothing. Understanding the precise nature of the tissue is the first step toward effective management and determining the most appropriate method for reduction or removal.
Understanding the Tissue and Its Origin
The tissue found in the underarm area is not always simple fat, which is why attempts at self-treatment often fail. There is a significant distinction between purely adipose tissue (typical axillary fat) and accessory breast tissue, which contains glandular elements. Accessory breast tissue, known clinically as polymastia, is a congenital condition resulting from the incomplete regression of the embryonic “milk line” during fetal development.
Because accessory breast tissue contains glandular cells, it behaves similarly to normal breast tissue. It is hormone-sensitive and may become tender, swollen, or more noticeable during hormonal fluctuations such as menstruation, pregnancy, or puberty. In contrast, simple axillary fat is soft, uniform, and composed purely of adipose cells, with its size primarily influenced by overall body weight and genetics. A medical professional must determine the exact composition of the tissue, often using imaging like an ultrasound or mammogram, to select an appropriate intervention.
Non-Surgical Reduction Methods
Non-surgical approaches are primarily effective for reducing axillary fullness composed of simple fat deposits. Weight management through dietary changes and increased physical activity can reduce the size of purely fatty deposits. Reducing overall body fat percentage often leads to a decrease in the size of the axillary fat pad.
Exercise focused on building muscle tone in the chest, back, and shoulders can improve the contour of the surrounding area. Targeted spot reduction of fat through exercise alone is not possible. For smaller, purely fatty collections, non-invasive treatments like cryolipolysis (CoolSculpting) or deoxycholic acid injections (Kybella) may be utilized off-label to destroy fat cells. These methods are not effective for dense, fibrous, or glandular accessory breast tissue.
Compression garments and specialized supportive wear can offer a temporary cosmetic solution by smoothing the underarm contour. These garments physically compress the tissue against the body, minimizing the visible bulge under clothing. While they do not reduce the volume of the tissue itself, they provide immediate relief from cosmetic self-consciousness. These strategies are ineffective for the deep, glandular tissue characteristic of true polymastia.
Surgical and Medical Interventions
For tissue that is dense, glandular, or unresponsive to weight management, professional medical intervention is the most reliable option for permanent removal. The choice of procedure depends on the tissue type, the volume of the mass, and the patient’s skin elasticity. A plastic surgeon or dermatologist will conduct a thorough consultation, which may include diagnostic imaging, before recommending a treatment plan.
Liposuction is often the preferred method when the tissue consists predominantly of soft, fatty deposits or a small amount of accessory glandular tissue. This minimally invasive procedure involves inserting a small cannula through a tiny incision, often placed discreetly in the armpit crease. Fat cells are gently suctioned out, resulting in minimal scarring and a relatively short recovery time.
Surgical excision becomes necessary for removing dense, fibrous, or large amounts of glandular tissue, which cannot be effectively removed by liposuction alone. This procedure involves a direct incision to remove the solid mass of glandular tissue and is often combined with liposuction for optimal contouring. The incision is strategically placed within the natural folds of the armpit to conceal the resulting scar.
The combination of liposuction and surgical excision is frequently used to address cases involving both significant fat and glandular tissue. By using both techniques, the surgeon can remove the hard glandular core while contouring the surrounding soft, fatty tissue. The procedure typically takes about an hour and a half and is performed under local or general anesthesia, depending on the extent of the removal.
Recovery from these surgical procedures varies, but patients are advised to limit physical activity for about six weeks. Initial healing, including the reduction of swelling and bruising, usually occurs within one to two weeks. While liposuction leaves small, inconspicuous scars, excision may result in a longer, more noticeable scar, often well-hidden in the axillary crease. This surgical approach offers the most definitive solution for permanently removing extra breast tissue in the armpit.