When we think about our breasts, we usually focus on how they look in a top or bikini, or how they feel after a workout. But what about that stubborn bulge that peeks out from the sides of your bra or tank top? For many women, this frustrating area—known as axillary breast tissue—can be a source of self-consciousness and even discomfort. Unlike regular body fat, this tissue (sometimes called “sideboob”) often requires more than just exercise to get rid of. New York plastic surgeon B. Aviva Preminger, MD is a leading expert in treating this concern and says it’s easier than ever to eliminate this stubborn issue once and for all.
What is Axillary Breast Tissue?
Axillary breast tissue is extra tissue that forms under the arm and often spills out from the sides of the breast. It can be made up of fat, glandular tissue, and, in some cases, even have extra nipples or areolae. “This concern affects approximately 2 to 6 percent of women and about 1 to 3 percent of men,” says Dr. Preminger. It’s often something people are embarrassed by.
Besides being a cosmetic concern, this condition can cause physical issues. Some people experience discomfort, swelling or restricted shoulder movement. “Hormonal changes during puberty, menstruation or pregnancy can make the tissue more noticeable and sometimes even painful; the area can even become engorged with milk during pregnancy and breastfeeding,” explains Dr. Preminger. “It’s not just about how it looks—axillary breast tissue can genuinely impact your quality of life.”
Why You Can’t Get Rid of It with Exercise Alone
Many patients find themselves frustrated after trying to reduce underarm bulges with weight loss and exercise alone. Unfortunately, this area doesn’t always respond the way you’d expect. Axillary breast tissue can be made up of both fat and glandular tissue, which makes it more stubborn than regular fat. “People come to me after trying everything from targeted arm exercises to dieting and they’re frustrated because it’s still there,” says Dr. Preminger. “That’s because this tissue is different from regular fat—especially when glandular tissue or extra skin is involved.”
Treatment Options: Finding What Works
Dr. Preminger recently published a paper that offers a guide for treating axillary breast tissue. The study looked at the outcomes of 43 patients and highlights several options, including nonsurgical treatments like CoolSculpting and Kybella, as well as surgical procedures like liposuction and tissue excision. The key, says Dr. Preminger, is finding the right treatment based on your unique needs.
“If the axillary breast tissue is mostly fat and there’s no loose skin, nonsurgical treatments like CoolSculpting can work well,” says Dr. Preminger. CoolSculpting is a noninvasive procedure that freezes and destroys fat cells, which are then naturally flushed out of your body. “It’s a great solution for someone with a mild amount of extra fat and tight skin,” she adds. “But patients should know it may take more than one treatment to get the results they want.”
In some cases, Dr. Preminger combines liposuction with BodyTite, a radio-frequency energy treatment that tightens skin while reducing fat. “This works really well for patients who have mild to moderate skin laxity,” she says. “BodyTite offers the added benefit of tightening the skin while getting rid of the excess fat.”
For others, however, nonsurgical treatments may not be enough. “If there’s both fat and loose skin, or if there’s glandular tissue present, we often recommend liposuction or surgical excision,” Dr. Preminger explains. Liposuction removes fat through small incisions, while excision is needed when there’s more substantial tissue to remove or if there’s glandular tissue that can’t be treated with liposuction alone.
When Extra Skin or Glandular Tissue Are Involved
Not all cases of axillary breast tissue are the same—how much skin laxity or glandular tissue you have can determine the best treatment. “If there’s a lot of loose skin, liposuction alone isn’t going to cut it,” says Dr. Preminger. “In those cases, we may need to perform a surgical excision to remove the extra tissue and tighten the skin.” Although this type of procedure leaves a scar, Dr. Preminger places it discreetly in the natural crease of the underarm so it’s barely noticeable.
Glandular tissue is another issue that can complicate things. Since this type of tissue doesn’t respond to fat-reducing treatments like CoolSculpting or liposuction, it needs to be surgically removed. “We sometimes see patients who have a combination of fat and glandular tissue,” Dr. Preminger says. “In these cases, surgery is necessary to get the best results.”
What to Expect from Treatments
Whichever treatment option you choose, Dr. Preminger emphasizes that these procedures are safe and effective when done by an experienced plastic surgeon. The study she participated in found that patients who underwent these treatments were highly satisfied with the results with very few complications. “There were no significant complications in our study, which is a great reassurance for patients considering these treatments,” Dr. Preminger notes.
Recovery time depends on the treatment. Nonsurgical options like CoolSculpting have little to no downtime, making them ideal for people who can’t afford to take time off work or their daily routines. Surgical options like liposuction or excision require a bit more recovery time—usually about one to two weeks. “Most patients are back to their normal routines fairly quickly,” Dr. Preminger says. “And they’re generally thrilled with the results.”
Is Treatment Right for You?
Ultimately, deciding whether to treat axillary breast tissue comes down to how much it bothers you. For some people, it’s just a small annoyance that only shows up in certain outfits. For others, it’s something they think about every day—whether it’s because of discomfort, limited mobility or just feeling self-conscious. The good news is that there are effective solutions out there, and you don’t have to live with it if it’s affecting your confidence or quality of life.
If you’re struggling with stubborn underarm bulge and nothing seems to help, there are options to consider. Whether you opt for a nonsurgical treatment, liposuction or a more extensive surgical approach, you can finally put that frustrating underarm fat behind you, and feel more confident in your own skin, and in clothing!
