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Axillary Accessory Breast: Optimal Time for Operation

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Abstract

Background

Accessory breasts are usually located in the axilla. Symptoms associated with an axillary accessory breast (AAB) may newly develop or worsen after pregnancy. After childbirth, AAB engorgement and hyperplasia may occur due to milk formation. We evaluated the optimal time for AAB excision and assessed variations in clinical presentations and surgical outcomes associated with pregnancy.

Methods

In total, 540 women whose symptoms began from puberty and underwent AAB excision were retrospectively analyzed. Group 1 comprised 416 patients who underwent operations before pregnancy, and Group 2 comprised 124 patients who underwent operations after childbirth. AABs were classified according to the Damsoyu–Lee (DL) classification. Satisfaction was measured by pain and cosmesis 3 months postoperatively.

Results

Group 2 had more patients with severe symptoms [DL class II (n = 8, 6.5%) and III (n = 15, 12.1%)] than Group 1 (p = 0.049). The specimen weight and liposuction volume were greater in Group 2. The reoperation rate was also higher in Group 2 [loosening skin excision (n = 4, 3.2%) and remnant gland excision (n = 3, 2.4%)] (p = 0.032). In Group 2, 31 (25%) patients had AAB engorgement after childbirth and 7 (5.6%) had milk secretion from the accessory nipple after childbirth. The overall satisfaction score was lower in Group 2 than 1.

Conclusions

Pregnancy may cause accessory breast gland hyperplasia. After childbirth, symptoms such as AAB engorgement and milk secretion from the accessory nipple may occur. The optimal timing for operation for AAB appears to be before the onset of pregnancy because of lower reoperation rates and greater patient satisfaction.

Level of Evidence IV

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Author information

Correspondence to Sung Ryul Lee.

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The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Surgical technique for axillary breast operation (WMV 35926 kb)

Surgical technique for axillary breast operation (WMV 35926 kb)

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Lee, S.R., Lee, S.G., Byun, G.Y. et al. Axillary Accessory Breast: Optimal Time for Operation. Aesth Plast Surg 42, 1231–1243 (2018). https://doi.org/10.1007/s00266-018-1128-8

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Keywords

  • Axillary accessory breast
  • Accessory breast enlargement after pregnancy
  • Classification of accessory breast