Treatment of Axillary Accessory Breast Tissue with Moderate-to-Severe Skin Laxity and Fat (Grade 3–4)

Clinical scenario

This protocol addresses accessory breast tissue presenting in the axilla with significant soft-tissue excess — ranging from moderate skin laxity with fat accumulation to severe involvement with additional glandular tissue.

Grading of axillary involvement

Grade 3 — Moderate skin laxity with fat in the axilla.
Grade 4 — Severe skin laxity combined with fat and glandular tissue in the axilla.

The distinction between these presentations is clinically significant, as the composition of the excess tissue — fat versus glandular — affects which surgical technique is appropriate.

Treatment approach

For both grade 3 and grade 4 presentations, a combined surgical approach to the axilla is indicated — addressing the excess fat and tissue together rather than suction alone. The complete, stepwise surgical protocol is available via the link below.

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References

If there is moderate skin laxity and fat in the axilla, we consider this "grade 3" (Fig. 6) and suggest liposuction with excision (Table 6).
For patients with severe skin laxity, fat, and glandular tissue in the axilla, we consider this "grade 4" (Fig. 7), and suggest liposuction with excision.
Glandular tissue is generally not amenable to liposuction alone; therefore, concurrent excision is necessary to remove unwanted tissue.

DOI: 10.1097/GOX.0000000000005189 View source ↗