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There is No "Axillary Tail": Rethinking the Assumption of James Spence.
David Teplica1,2,3, Emmett Cooney2,4, Eileen Jeffers1
1The 803 Foundation, Chicago, Ill.
Plastic and Reconstructive Surgery. Global Open
|February 16, 2022
Summary
The "axillary tail of Spence" does not exist as a continuous fat extension. Anatomical study reveals distinct fat pads on the chest wall, challenging long-held surgical and anatomical beliefs.
Area of Science:
- Anatomy
- Surgical Anatomy
- Plastic Surgery
Background:
- The "axillary tail of Spence" is a widely accepted concept describing fat extending from the breast into the axilla.
- This anatomical feature has been historically significant in surgery, oncology, plastic surgery, and anatomy since 1871.
Purpose of the Study:
- To investigate the anatomical existence of the "axillary tail of Spence."
- To clarify the adipose tissue distribution in the superolateral breast and axillary region.
Main Methods:
- Pinch-testing and topographical mapping of 316 patients undergoing breast or gynecomastia surgery.
- Calipre pinch-testing and topographical mapping of 20 research participants to define fat pad anatomy.
Main Results:
- No contiguous "axillary tail of Spence" was found; instead, distinct focal fat mounds were observed.
- An "axillary breast mound" and a "lateral chest wall tail" were identified, separate from the primary breast.
- The "lateral chest wall tail" did not angle towards the axilla, and a groove often formed between the axillary mound and the breast.
Conclusions:
- The "axillary tail of Spence" as a continuous structure is anatomically inaccurate.
- The outer chest's adipose tissue is composed of three distinct structures: the axillary mound, primary breast mound, and lateral chest wall tail.
- This finding necessitates a re-evaluation of anatomical descriptions and surgical approaches related to this region.
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