Armpit Rolls and Tail of the Breast

Tuesday, May 22, 2018

Armpit Rolls and Tail of the Breast

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Armpit Rolls

Armpit rolls are folds of skin and fat that lie at the upper front edge of the armpit. They make some women self conscious about wearing spaghetti strap tops or strapless dresses and bras. Their presence can be independent of breast size or patient weight

Armpit Rolls Are Independent of Breast Size as Seen Before and After Breast Reduction Surgery

and they can be asymmetric in size or even absent on one side.

Armpit Rolls Can be Present on Only One Side

In older individuals they can deflate leaving just a fold of excess skin.

Deflated Left Armpit Fold in Older Patient

They are composed of a variable combination of skin, fat and glandular breast tissue. Their removal by liposuction is a common part of breast reduction surgery where they are mostly composed of fat rather than glandular breast tissue. When looking at before and after breast reduction photos they may be more visible on side views. Ignoring them in breast reduction surgery yields a less than optimal result. In massive weight loss patients the skin component is much larger and in most cases some removal of the excess skin is required. The surgical modalities employed therefore depend on contents of the roll. As mentioned most patients do well with just liposuction or even non-surgical fat removal by injection, freezing etc.. If the roll is mostly glandular direct excision via an armpit incision is the best option. In cases where the pinch thickness of the roll is minimal or there is still a visible roll after liposuction or direct excision the skin is removed as it would be in an arm lift described in my previous blog Upper Arm Lift - Brachioplasty. The upper arm lift is composed of an inner upper arm segment and when necessary armpit and side of chest extensions. In the case of armpit rolls only the armpit extension would be required i.e. armpit portion of an L-lift brachioplasty with or without z-plasties hiding the scar in the armpit behind the muscle.