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Axillary breast tissue, also referred to as accessory breast tissue in medical terms, is a common occurrence in women. This condition involves the presence of additional breast tissue in the axillary area, resulting in varying degrees of discomfort, pain, and emotional distress. In order to address these concerns, the surgical intervention known as axillary breast tissue removal is employed, with the goal of effectively reducing these symptoms by removing the excess tissue.

Axillary breast is a common condition that affects many women, characterized by the presence of extra breast tissue in the axillary area. This condition can be treated by a number of treatment approaches;

• 1. Surgical Excision: Surgical excision is the primary approach for treating axillary breast. This procedure involves the complete removal of excess breast tissue through an armpit incision. The goal is to eliminate the additional tissue while preserving the normal breast and minimizing any visible scarring. Surgical excision is typically performed under general anesthesia, ensuring patient comfort and optimal outcomes.
• 2. Liposuction: For cases where the axillary breast tissue consists mainly of fat, liposuction can be an appropriate treatment option. This minimally invasive procedure employs a suction device to remove excess fat from the armpit area. Liposuction is particularly suitable for individuals with smaller axillary breasts who desire a less invasive treatment approach.
• 3. Hormonal Therapy: In some instances, axillary breast tissue can be influenced by hormonal changes during puberty, pregnancy, or lactation, resulting in enlargement or discomfort. Hormonal therapy may be prescribed to help regulate hormonal balance and alleviate associated symptoms. This targeted approach aims to address the underlying hormonal factors contributing to axillary breast concerns.
• 4. Non-Surgical Treatments: When axillary breast tissue is minimal or does not cause significant problems, non-surgical options can be considered. These may include the use of compression garments or padding to camouflage or minimize the appearance of the axillary breast. Non-surgical treatments provide a conservative approach for individuals seeking aesthetic improvement without invasive procedures.

Surgical intervention for Axillary Breast becomes necessary based on considerations such as;

• Cosmetic Concerns: Many individuals seek surgical intervention for axillary breast due to cosmetic reasons. When the presence of axillary breast tissue causes self-consciousness or negatively impacts body image and self-confidence, surgical removal can be considered to achieve a more desired aesthetic appearance.
• Discomfort or Pain: Axillary breast tissue can sometimes lead to discomfort or pain, particularly during physical activities or when pressure is applied. If the presence of axillary breast tissue results in persistent pain or discomfort that hinders daily life, surgery may be recommended to alleviate these symptoms effectively.
• Enlargement or Changes: Axillary breast tissue can undergo changes, such as enlargement, during hormonal fluctuations like puberty, pregnancy, or lactation. In cases where the axillary breast tissue becomes significantly enlarged, causing discomfort or interfering with regular activities, surgical intervention may be necessary.
• Recurrent Infections or Inflammation: In certain instances, axillary breast tissue may be prone to recurrent infections or inflammation. If conservative treatments such as antibiotics or anti-inflammatory medications fail to alleviate the issue, or if the infections persistently recur, surgical removal of the problematic axillary breast tissue may be considered.

The diagnosis and evaluation of axillary breast in preparation for surgery involve a series of diagnostic steps and tests;

• Complete Blood Count (CBC): A CBC test is commonly performed to evaluate the patient's overall health and assess the levels of red blood cells, white blood cells, and platelets. This comprehensive blood test provides valuable insights into any underlying blood disorders or abnormalities that may impact the surgical procedure or postoperative recovery.
• Liver Function Test: A liver function test is conducted to assess the functioning of the liver and detect any liver-related abnormalities. This test helps determine the patient's liver health, which is essential for ensuring the safe administration of anesthesia and assessing the patient's overall suitability for surgery.
• X-ray: An X-ray may be recommended to evaluate the chest area and surrounding structures. It provides a detailed image that aids in assessing the size, location, and characteristics of the axillary breast tissue. This information is valuable for surgical planning and determining the optimal approach for removal.
• Electrocardiogram (ECG): An electrocardiogram is a non-invasive test that records the electrical activity of the heart. It helps identify any cardiac abnormalities or conditions that may require additional precautions during surgery. Ensuring the patient's cardiac health is essential for a safe and successful surgical procedure.

The axillary breast operation offers relief from discomfort and improves body aesthetics, promoting self-confidence. The operation typically lasts approximately an hour, ensuring a focused and efficient approach to the treatment process. Here is a detailed overview of how the axillary breast operation is performed;

• Before the procedure
1. Preoperative Assessment: Prior to the surgery, you will undergo a thorough preoperative assessment. This may include a review of your medical history, physical examination, and discussions about any pre-existing medical conditions or medications you are taking.
2. Vitals and Preoperative Tests: Your vital signs, such as blood pressure, heart rate, and temperature, will be measured to ensure your overall health condition before the surgery. Additionally, preoperative tests such as blood tests, electrocardiogram (ECG), and chest X-rays may be conducted to assess your baseline health and identify any potential risks.
3. Preparing for Surgery: On the day of the operation, you will be guided to change into a hospital gown. An intravenous (IV) line may be inserted into your vein to administer fluids, medications, or anesthesia during the surgery. This allows the medical team to maintain your hydration and deliver necessary medications smoothly. Patient’s armpit hair will also be shaved-off by the medical team.
4. Marking and Documentation: Before the operation, the surgical site (axillary area) will be marked by the surgeon. This ensures precise planning and helps guide the incision and tissue removal during the procedure. The markings also serve as a reference point for the surgical team.
• During the procedure
1. Anesthesia: The axillary breast operation can be carried out utilizing either local anesthesia with sedation or general anesthesia, based on the specific surgical approach and patient's preferences. General anesthesia guarantees complete unconsciousness and pain management throughout the procedure, typically preferred for excision-based surgery. Conversely, local anesthesia with sedation ensures patient comfort and relaxation during liposuction, and it is administered in cases where liposuction is performed.
2. Incision: The surgeon carefully plans the location and size of the incision in the armpit region to minimize visibility and scarring. The precise pattern and length of the incision are determined based on the amount of excess axillary breast tissue and the chosen surgical approach.
3. Tissue Removal: During the procedure, the surgeon skillfully removes the excess breast tissue, employing a combination of excision (surgical cutting) and liposuction (suction-assisted removal of fat) techniques. This meticulous approach aims to preserve the normal breast tissue and maintain natural breast contours for a more desirable outcome.
4. Nipple and Areola Adjustment (if required): In certain cases, adjustments to the position or appearance of the nipple and areola may be necessary for achieving optimal symmetry and aesthetics. The surgeon may reposition or resize the nipple and areola to ensure a balanced and harmonious result.
5. Closure: After removing the excess axillary breast tissue and making any necessary adjustments, the surgeon meticulously closes the incisions using sutures or surgical adhesive. Special attention is given to precise closure techniques to minimize scarring and promote optimal healing.
• After the procedure
1. Monitoring: Medical professionals will closely monitor your vital signs, such as heart rate, blood pressure, and oxygen levels, to ensure a stable and safe recovery.
2. Pain Management: You will be provided with pain medication as prescribed by your surgeon to manage any discomfort or pain resulting from the surgery. The medical team will regularly assess your pain levels and adjust the medication accordingly.
3. Observation: The recovery room staff will observe you for any immediate post-operative complications, such as bleeding, infection, or adverse reactions to anesthesia.
4. Wound Care: The surgical incisions made during the procedure will be carefully monitored for proper healing. The medical team will provide instructions on how to care for the incisions, including dressing changes, keeping the area clean, and any specific precautions to take.
5. Recovery Instructions: You will be given specific instructions regarding activities, movement, and restrictions during the initial recovery period. This may include guidance on avoiding strenuous activities, lifting heavy objects, or engaging in certain exercises that could strain the surgical area.
6. Discharge Planning: Depending on your overall condition and the specific instructions from your surgeon, you will be discharged from the hospital or surgical facility once you have sufficiently recovered. The medical team will provide information about follow-up appointments, medication schedules, and any additional care requirements.
7. Recovery Timeline: The recovery period after axillary breast surgery can vary from person to person. Your surgeon will guide you on the expected timeline for healing, returning to normal activities, and any potential restrictions or precautions during the recovery phase.

Axillary breast surgery in India offers numerous benefits to individuals seeking relief from the physical and emotional challenges associated with axillary breast tissue. Here are some key benefits of axillary breast surgery;

• Improved Contours: Axillary breast surgery helps eliminate undesirable contours in the underarm area, resulting in a more balanced and aesthetically pleasing appearance. By removing excess breast tissue, the procedure enhances body proportions and symmetry.
• Enhanced Mobility: With the reduction of axillary breast tissue, patients often experience improved mobility of the arms. This allows for greater freedom of movement and a more comfortable range of motion.
• Clothing Comfort: The presence of axillary breast tissue can cause irritation and discomfort when wearing certain types of clothing. Axillary breast surgery helps alleviate these issues, allowing individuals to wear their desired clothing without any hindrance or discomfort.
• Concealed Scarring: Skillfully performed axillary breast surgery minimizes the visibility of scars. Surgeons strategically place incisions within the natural crease of the armpit fold, ensuring that any resulting scars are well-hidden. This approach helps maintain the aesthetic integrity of the underarm area, with scars being inconspicuous and not easily noticeable.

Here are some possible side effects associated with axillary breast surgery;

• Infection: While uncommon, there is a risk of developing an infection after surgery. Precautions are taken to minimize this risk, such as sterile surgical techniques and the use of antibiotics. However, it is important to closely follow post-operative care instructions to further reduce the likelihood of infection.
• Wound Separation: In some cases, the incisions made during axillary breast surgery may experience separation or delayed healing. This can lead to a wound opening up or becoming wider. Close monitoring and adherence to proper wound care instructions can help reduce the risk of wound separation.
• Hematoma and Seroma: Hematoma refers to the collection of blood within the surgical site, while seroma refers to the accumulation of fluid. These fluid collections can sometimes occur after axillary breast surgery. Drains may be placed during surgery to minimize the risk of hematoma and seroma formation, and post-operative monitoring and management are important to address these issues if they arise.
• Undesirable Results: While rare, there is a possibility of achieving results that may not meet the patient's expectations. This can include asymmetry, contour irregularities, or unsatisfactory aesthetic outcomes. Thorough pre-operative consultations and discussions with the surgeon can help manage expectations and ensure realistic goals are set.

Here are some key aspects to consider during the recovery period;

• Swelling, Bruising, and Numbness: It is common to experience some swelling, bruising, and numbness in the treated area. These effects gradually subside over the course of a few weeks as the body heals.
• Range of Motion and Arm Exercises: As scar tissue forms around the incision, the range of motion in the arm and shoulder may become temporarily restricted. Performing prescribed arm exercises helps maintain flexibility and prevent stiffness.
• Incision Care: Proper care of the incision is vital for optimal healing. Keeping the wound clean and dry is essential. Washing the incision with soap and water and gently patting it dry with a clean towel are recommended. It is important to wash hands before and after touching the incision. Unless there are drainage tubes in place, the incision can be left uncovered. Protecting the scars from sun exposure for at least a year is advised.
• Showering Instructions: Showering can usually be resumed 24 hours after the surgery. Taking warm showers can provide relaxation, but it is important to avoid direct water pressure on the incision site.
• Activities: Following the prescribed medication regimen is essential. Light walking and exercise can help improve blood circulation and promote healing. Wearing a compression bra or garment aids in skin retraction. Patients can gradually resume physical activities based on their comfort level. Returning to work can typically be done within a week, but it may vary depending on individual circumstances.
• Restrictions: Strenuous activities should be avoided for about three to four weeks or until the patient has completely healed. Swimming, hot tubs, baths, and saunas should be avoided until approved by the doctor. It is important not to drive or consume alcohol while on prescription medications.
• Diet: A balanced diet rich in fiber, including vegetables, fresh fruits, cereals, and whole grains, is recommended to support overall health and facilitate healing.