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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

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Accessory Axillary Breast Management: Is Primary Skin Excision Necessary?

¹Department of Plastic Surgery, Fortis Hospital, Richmond Road, Bangalore, Karnataka, India.

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India

|December 30, 2024

Summary

Surgical management of axillary breasts can be improved by avoiding primary skin excision. A modified approach focusing on liposuction and gland excision, with secondary skin management, minimizes scarring and improves outcomes.

Keywords:

accessory breast axilla axillary breast breast excision liposuction

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Area of Science:

Plastic Surgery
Anatomy

Background:

Axillary breasts, accessory breast tissue in the armpit, affect 2-6% of women and 1-3% of men.
Incidence varies ethnically, being higher in Asian populations, particularly Japanese.

Purpose of the Study:

To evaluate a modified surgical technique for axillary breast management that minimizes scarring.
To compare outcomes of the modified technique against traditional methods involving primary skin excision.

Main Methods:

A modified surgical protocol for axillary breast removal was employed, omitting primary skin excision.
Liposuction of axillary breast tissue combined with gland and skin excision was performed, with secondary skin management for excess.

Main Results:

The modified technique achieved excellent aesthetic results with minimal scarring.
Avoidance of primary skin excision prevented long, widening scars, contractures, and restricted arm movement.

Conclusions:

A modified surgical approach, avoiding primary skin excision for axillary breasts, offers superior cosmetic outcomes and functional results.
Secondary management of skin excess is recommended over primary excision to prevent adverse scarring and movement limitations.