The appearance of extra tissue under the armpit, often called the “bra bulge” or axillary tissue, is a frequent cosmetic concern for many people. This tissue creates an unwanted contour, causing discomfort or self-consciousness, especially when wearing fitted clothing or sleeveless tops. The presence of this tissue is common and generally benign, but understanding its underlying composition is the first step toward finding an effective solution. Addressing the concern effectively requires distinguishing between the different types of tissue that can accumulate in the axilla.
Determining the Cause of Extra Tissue
The tissue causing the bulge under the armpit can be one of three distinct types, and the appropriate method of removal depends entirely on which one is present. The most common cause is the presence of localized fat deposits, known as the axillary fat pad, which is subcutaneous fat stored just outside the main breast area. Like fat in other parts of the body, this accumulation is often influenced by genetics, overall weight gain, and hormonal fluctuations.
A second possibility is true excess skin laxity, which typically occurs following significant weight loss or as a natural consequence of the aging process. When the skin loses its natural elasticity, it can hang loosely, creating a visible fold or bulge in the underarm area.
The third, less common cause is accessory breast tissue, medically termed polymastia or supernumerary breast tissue, which affects approximately 2% to 6% of women. This tissue is composed of glandular breast tissue, similar to that found in the main breast, and is a remnant of the embryonic “milk line.” Because this tissue is hormonally responsive, it may swell, become tender, or become more noticeable during menstruation, pregnancy, or menopause, indicating that it is glandular tissue rather than simple fat.
Non-Surgical and Lifestyle Adjustments
For tissue that is primarily localized fat, initial efforts should focus on generalized weight management through consistent diet and exercise routines. A reduction in overall body fat percentage will often lead to a gradual decrease in the size of the axillary fat pad, as the body draws energy from fat stores across all areas.
While overall weight loss is effective, the concept of “spot reduction” of fat through targeted exercise is not physiologically possible. Performing exercises that strengthen the chest, back, and shoulders, such as pushups, rows, and chest presses, will build muscle tone in the surrounding areas. This muscle development can improve the appearance of the underarm contour by providing a firmer, more defined foundation beneath the skin.
For a temporary cosmetic solution, compression garments or properly fitted brassieres can offer immediate, non-invasive relief. A bra that is too tight or ill-fitting can inadvertently push the soft tissue of the chest wall and armpit area into a more noticeable bulge. Choosing supportive garments that fully encapsulate the breast tissue and the surrounding area can smooth the contour, minimizing the visible appearance of the extra tissue.
Medical and Cosmetic Removal Procedures
When lifestyle adjustments do not yield the desired results, or the tissue consists of glandular material or excess skin, professional medical interventions become the primary option. Minimally invasive treatments are reserved for localized fat deposits and involve technology that destroys fat cells without surgical incisions. One such method is cryolipolysis, which uses controlled cooling to lower the temperature of the fat cells to the point of irreversible damage.
Another non-surgical approach uses injectable treatments containing deoxycholic acid, a substance naturally found in the body that helps break down and absorb dietary fat. This solution is injected directly into the fat pad, where it destroys the fat cells, which are then cleared away by the body’s lymphatic system over several weeks. These procedures typically require multiple sessions to achieve a noticeable result and involve minimal downtime.
For larger areas of fat or cases where the tissue is denser, axillary liposuction is a surgical procedure. It involves inserting a thin tube called a cannula through a small incision, often hidden within the natural armpit crease. The surgeon uses the cannula to suction out the excess fatty tissue, providing more immediate volume reduction than non-surgical options.
However, when the issue is significant skin laxity or the presence of hormonally active accessory breast tissue, surgical excision is often the necessary approach. Excision involves physically cutting out the excess glandular tissue or loose skin, sometimes as an extension of a brachioplasty, or arm lift. This technique is required because glandular tissue does not respond to liposuction or non-surgical fat destruction methods.
During an excision procedure, the surgeon carefully removes the solid tissue through an incision, which is strategically placed to hide the resulting scar within the armpit’s natural folds. If both fat and glandular tissue are present, the surgeon may combine liposuction to remove the fat with subsequent excision to remove the dense glandular core. Recovery from excision is more involved than liposuction, typically requiring patients to avoid strenuous arm activity for three to four weeks.