AXILLARY BREASTS
Understanding axillary breasts:
Axillary breasts represent a common clinical entity affecting approximately 6% of women, manifesting as ectopic breast tissue located within the axillary region. This aberrant breast tissue demonstrates identical physiological behaviour to normally positioned mammary tissue, undergoing cyclical changes in response to hormonal fluctuations throughout the menstrual cycle, pregnancy, and lactation periods.
The condition typically presents as painless soft tissue masses beneath the arms, which may be unilateral or bilateral. In certain cases, rudimentary nipple formation may accompany the ectopic tissue. Over time, particularly following pregnancy and lactation cycles, the tissue may develop ptosis and become increasingly prominent, leading to both functional and aesthetic concerns.
Clinical presentation:
Patients with axillary breasts commonly experience multifaceted challenges that extend beyond the physical manifestation. The tissue enlargement becomes particularly pronounced during pregnancy and lactation, often accompanied by increased tenderness and discomfort that mirrors the cyclical pain patterns experienced in normal breast tissue during menstruation.
From a practical standpoint, patients frequently report significant lifestyle limitations. The presence of axillary breast tissue creates difficulties with clothing selection, particularly when attempting to wear fitted garments or sleeveless attire. It leads to considerable impact on self-confidence and overall quality of life, with many patients expressing concerns about their appearance in social and professional settings. Additionally, the anatomical location predisposes to increased perspiration accumulation, creating hygiene challenges and potential skin irritation.
Surgical approach:
In our clinical practice, we have developed a comprehensive surgical approach that prioritizes patient comfort, aesthetic outcomes, and rapid recovery. We routinely perform bilateral axillary breast excision under local anesthesia, which has proven superior to general anesthesia in this patient population for several reasons.
The procedure involves careful surgical planning with incision placement designed to ensure scars remain hidden within the natural contours of the axilla, avoiding any anterior positioning that might compromise aesthetic results. During the excision, we remove an elliptical portion of skin along with the underlying ectopic breast tissue. An aspect of our technique involves addressing the frequently encountered prominence medial to the axillary fold, which, while not always composed of true breast tissue, significantly impacts the overall contour. We perform simultaneous contouring of this area through the same axillary incision, achieving superior aesthetic results without additional scarring.
Our preference for local anesthesia stems from clinical experience demonstrating enhanced patient outcomes. This approach eliminates the common side effects associated with general anesthesia, including nausea and vomiting, while significantly improving safety profiles. The technique proves particularly advantageous for our patient demographic, many of whom are mothers with young children who prefer returning home the same evening rather than requiring overnight hospitalization.
Post-operative management and recovery:
Our post-operative care protocol is based on patient outcomes and feedback. Immediately following closure, we apply specialized bolster dressings secured with surgical tape, providing wound support during the critical initial healing phase. Patients receive detailed instructions emphasizing the importance of complete rest during the first 72 hours post-operatively.
The first follow-up appointment occurs between the third and fourth post-operative days, during which we remove the bolster dressings and apply fresh compression dressings along with supportive tape. At one week, we remove both the compression tape and sutures, transitioning patients to daily wound cleansing with application of protective padding and a compression garment.
Our recovery timeline allows for gradual activity progression, with light activities permitted after the initial three-day rest period. We allow driving at two weeks post-operatively, with complete activity clearance at one month. This staged approach has resulted in optimal healing outcomes while minimizing complications.
Complication management:
While the vast majority of our patients experience uncomplicated recoveries, there can be potential complications. The most commonly encountered issue involves temporary altered sensation along the medial arm and elbow region, resulting from proximity to the intercostobrachial nerve during surgical dissection. This nerve, responsible for sensation over the medial upper arm, travels in close anatomical relationship to axillary breast tissue. In our experience, these sensory changes typically resolve spontaneously without requiring additional intervention.
Serious complications including infection, significant wound disruption, and prominent scarring are uncommon. The overall complication rate remains consistently low, contributing to high patient satisfaction scores.
Patient satisfaction:
The psychological and social benefits of axillary breast correction usually exceed patient expectations in our practice. Beyond the obvious aesthetic improvements, patients report enhancements in self-confidence and overall quality of life. The ability to wear previously avoided clothing styles, participate in physical activities without self-consciousness, and engage in social situations with renewed confidence represents the true measure of surgical success.
Related topics,
1. Reduction mammaplasty (Breast reduction surgery) for enlarged breasts.
Axillary breasts represent a common clinical entity affecting approximately 6% of women, manifesting as ectopic breast tissue located within the axillary region. This aberrant breast tissue demonstrates identical physiological behaviour to normally positioned mammary tissue, undergoing cyclical changes in response to hormonal fluctuations throughout the menstrual cycle, pregnancy, and lactation periods.
The condition typically presents as painless soft tissue masses beneath the arms, which may be unilateral or bilateral. In certain cases, rudimentary nipple formation may accompany the ectopic tissue. Over time, particularly following pregnancy and lactation cycles, the tissue may develop ptosis and become increasingly prominent, leading to both functional and aesthetic concerns.
Clinical presentation:
Patients with axillary breasts commonly experience multifaceted challenges that extend beyond the physical manifestation. The tissue enlargement becomes particularly pronounced during pregnancy and lactation, often accompanied by increased tenderness and discomfort that mirrors the cyclical pain patterns experienced in normal breast tissue during menstruation.
From a practical standpoint, patients frequently report significant lifestyle limitations. The presence of axillary breast tissue creates difficulties with clothing selection, particularly when attempting to wear fitted garments or sleeveless attire. It leads to considerable impact on self-confidence and overall quality of life, with many patients expressing concerns about their appearance in social and professional settings. Additionally, the anatomical location predisposes to increased perspiration accumulation, creating hygiene challenges and potential skin irritation.
Surgical approach:
In our clinical practice, we have developed a comprehensive surgical approach that prioritizes patient comfort, aesthetic outcomes, and rapid recovery. We routinely perform bilateral axillary breast excision under local anesthesia, which has proven superior to general anesthesia in this patient population for several reasons.
The procedure involves careful surgical planning with incision placement designed to ensure scars remain hidden within the natural contours of the axilla, avoiding any anterior positioning that might compromise aesthetic results. During the excision, we remove an elliptical portion of skin along with the underlying ectopic breast tissue. An aspect of our technique involves addressing the frequently encountered prominence medial to the axillary fold, which, while not always composed of true breast tissue, significantly impacts the overall contour. We perform simultaneous contouring of this area through the same axillary incision, achieving superior aesthetic results without additional scarring.
Our preference for local anesthesia stems from clinical experience demonstrating enhanced patient outcomes. This approach eliminates the common side effects associated with general anesthesia, including nausea and vomiting, while significantly improving safety profiles. The technique proves particularly advantageous for our patient demographic, many of whom are mothers with young children who prefer returning home the same evening rather than requiring overnight hospitalization.
Post-operative management and recovery:
Our post-operative care protocol is based on patient outcomes and feedback. Immediately following closure, we apply specialized bolster dressings secured with surgical tape, providing wound support during the critical initial healing phase. Patients receive detailed instructions emphasizing the importance of complete rest during the first 72 hours post-operatively.
The first follow-up appointment occurs between the third and fourth post-operative days, during which we remove the bolster dressings and apply fresh compression dressings along with supportive tape. At one week, we remove both the compression tape and sutures, transitioning patients to daily wound cleansing with application of protective padding and a compression garment.
Our recovery timeline allows for gradual activity progression, with light activities permitted after the initial three-day rest period. We allow driving at two weeks post-operatively, with complete activity clearance at one month. This staged approach has resulted in optimal healing outcomes while minimizing complications.
Complication management:
While the vast majority of our patients experience uncomplicated recoveries, there can be potential complications. The most commonly encountered issue involves temporary altered sensation along the medial arm and elbow region, resulting from proximity to the intercostobrachial nerve during surgical dissection. This nerve, responsible for sensation over the medial upper arm, travels in close anatomical relationship to axillary breast tissue. In our experience, these sensory changes typically resolve spontaneously without requiring additional intervention.
Serious complications including infection, significant wound disruption, and prominent scarring are uncommon. The overall complication rate remains consistently low, contributing to high patient satisfaction scores.
Patient satisfaction:
The psychological and social benefits of axillary breast correction usually exceed patient expectations in our practice. Beyond the obvious aesthetic improvements, patients report enhancements in self-confidence and overall quality of life. The ability to wear previously avoided clothing styles, participate in physical activities without self-consciousness, and engage in social situations with renewed confidence represents the true measure of surgical success.
Related topics,
1. Reduction mammaplasty (Breast reduction surgery) for enlarged breasts.
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Preoperative image of axillary breast of the right
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Early postoperative image of operated axillary breast taken at one week.
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Axillary breasts before and after
Axillary breasts before surgery
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Axillary breasts after surgery
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