- Armpit fat and bra bulge may in fact be accessory breast tissue, loose skin, or both.
- Surgical treatments to reduce bra bulge include liposuction and skin excision.
- Non-invasive procedures may be effective, but generally provide less dramatic results.
Unsightly bra bulge is difficult to target through diet and exercise, and easy to spot when you’re wearing tank tops or sleeveless blouses. It’s no wonder so many people turn to cosmetic treatments to get rid of it.
Which procedure you choose will depend on how much time and money you want to commit. Here’s a rundown of your options.
What Causes Bra Bulge?
In some cases, bra bulge isn’t caused by armpit fat or excess weight at all. Other possible causes include:
- Poor muscle tone, which can result in more sagging.
- Excess skin following dramatic weight loss.
- Accessory (axillary) breast tissue, which can grow along the milk lines in the armpit region.
- A poorly contoured bra, which can push skin and breast tissue out and around the straps.
A plastic surgeon can help you determine the best course of action depending on your individual concerns.
Liposuction for Armpit Fat
Liposuction breaks up pockets of resistant fat and removes them through suction. This shapes the body by contouring areas that don’t respond to proper diet and exercise. Liposuction can also be performed to remove accessory breast tissue.
The procedure is performed under anesthesia. Your surgeon will use a cannula tube to drain the fat through small incisions performed in targeted areas.
Different liposuction techniques may be employed, depending on your needs and the surgeon’s area of expertise:
- Tumescent — A solution is injected into the area to numb it and help dissolve the fat.
- Ultrasound-assisted — Fat is broken up using sound waves.
- Laser-assisted — A fiber optic laser cable is inserted under the skin to heat and melt the fat.
- Power-assisted — Vibration is used to break up stubborn fat before it’s suctioned away.
The procedure itself typically takes one or two hours, regardless of the chosen technique. Your plastic surgeon will then send you home with some helpful tools, including absorbent pads to dress the area, compression garments, pain medications as needed, and antibiotics.
For the first few days it’s best to limit unnecessary physical activity, keep the area clean and dry, and simply relax. Expect some pain, swelling, and bruising.
Afterwards, you can return to work upon your surgeon’s recommendation. However, you should still limit excessive physical activity and wear your compression garments.
After a few weeks, and with your doctor’s approval, you can stop wearing the compression garments and resume normal physical activity.
Risks and Complications
When performed by an expert plastic surgeon, liposuction is very safe. However, it does involve a certain number of risks and potential complications.
- Allergic reaction — You may react negatively to local or general anesthesia.
- Infection — Look for signs of infection like purulent (pus-like) discharge and inflammation.
- Bleeding — Keep an eye out for excessive bleeding.
- Fat embolism — Fat can break away from the treatment area and become lodged in a blood vessel.
- Kidney and heart problems — Certain types of liposuction involve dramatic changes in the body’s fluid levels, putting stress on the heart and kidneys.
- Contour deformities — Uneven fat removal may cause the skin to take on a wavy or lumpy appearance.
- Loose skin — If enough fat is removed or you generally have poor skin elasticity, you may see some loose or sagging skin well after the procedure.
Liposuction varies widely in cost. It can cost as little as $2,000 (excluding anesthesia and other fees), or as much as $8,000, especially if several areas are treated. If you are only treating your underarm area, you will likely pay less, but still expect the procedure to cost several thousands of dollars.
» To learn more about how liposuction can contour the area under your arms, use our forum to ask doctors questions and read other patients’ testimonials.
Skin Excision or Underarm Lift
An underarm lift can be performed to remove excess skin after liposuction or dramatic weight loss.
An arm lift, also known as brachioplasty, is essentially a face lift for your upper arms. Depending on your needs and your surgeon’s recommendations, you can get a full arm lift or simply target the underarm region.
During a traditional arm lift, your surgeon will administer local anesthesia and make an incision from the armpit to the elbow. He or she will then remove excess tissue and fat deposits. The skin is then stitched up and bandaged. If you only wish to target your armpit area, a procedure also known as a mini arm lift or limited incision brachioplasty, then your incision will be significantly smaller.
Some surgeons will perform a skin excision and liposuction at the same time. This may not always be necessary, as skin will often firm up after liposuction. Your surgeon may however recommend this if you are having a significant amount of fat removed or already have issues with loose skin.
If armpit fat is due to accessory breast tissue, the tissue and excess skin can be excised. The size and location of the incision will depend on the extent of the accessory tissue.
Postoperative care will depend on the size of the treated area and the length of the incision. You will be sent home with painkillers, antibiotics, and a compression garment to reduce swelling. It is recommended to stay at home from work for one week after an underarm lift.
You will likely experience considerable pain in the first 48 hours after surgery, so you should avoid moving your arms during that time. You will be required to go in for a follow-up afterwards, to change the dressings.
Limit physical activity to walking for the first week after surgery. You can attempt some more involved exercise after that, but avoid any exercise that targets your arms for at least a month. At six weeks, you can resume all of your normal activities.
Risks and Complications
Similar to liposuction, there is some risk of bleeding, infection, and allergic reaction to anesthesia. Skin excisions come with additional potential complications.
- Scarring — This surgery involves a fairly long incision, which increases the risk of scarring issues.
- Hematoma — An accumulation of blood under the skin can cause swelling and pain.
- Seroma — An accumulation of fluid under the skin can harden and need to be surgically removed.
- Nerve damage — Damaged nerves can result in loss of sensation or even chronic pain.
- Fat necrosis — Damaged fat under the skin can form deposits that lead to cysts, which may be hard and painful.
- Suture complications — Your sutures should absorb into the skin. In rare cases, sutures can push up to the skin’s surface and cause irritation.
A basic removal of accessory breast tissue costs anywhere from $800 – $1,500. According to the American Society of Plastic Surgeons, a full arm lift costs $4,257 on average.
CoolSculpting for Bra Fat
Non-invasive fat removal and skin tightening procedures require no incisions and far less recovery time than their surgical counterparts. However, the results are less dramatic and may require repeat visits.
CoolSculpting is a body contouring procedure that targets specific areas with freezing temperatures, destroying fat cells in a process known as cryolipolysis. In doing so, CoolSculpting can reduce 20-25% of fat in the treated area.
A gel pad is first placed over the treatment area to protect the skin from direct contact with the device. The skin is then suctioned up and sandwiched between the cooling pads. Once the device is secure, the cooling begins.
CoolSculpting is performed without anesthesia, and may cause slight discomfort. Although a single treatment session generally lasts more than an hour, it may be significantly shorter for smaller areas under the arms.
Several sessions are required for best results, which is important to factor in when considering cost.
Coolsculpting comes with minimal recovery time. In fact, exercise is encouraged for optimal results, and you can also return to work immediately after.
You may experience some stinging or aching in the treated area for a couple of weeks. This pain could be present from the start, or begin later in the recovery process. In either case, it typically goes away on its own. This is also true of any bruising or skin discoloration.
Don’t expect results right away. CoolSculpting simply helps break down the fat — your body will eliminate it naturally in the days and weeks that follow.
Risks and Complications
Aside from minor bruising, swelling, and discomfort post treatment, there are a few potential complications you should be aware of:
- Lightheadedness — You may experience some vasovagal symptoms, such as dizziness, flushing, nausea, and even fainting during or shortly after the procedure.
- Freeze burn — You may develop a 1st or 2nd degree burn from the procedure. In extremely rare cases, patients have gotten frostbite.
- Hardening of skin — Also called subcutaneous induration, the treated area could develop hard bumps shortly after the procedure.
- Paradoxical Hyperplasia — Fat cells in the treated area grow instead of shrinking. This can happen several months after treatment and is extremely rare.
Coolsculpting can range from $600 to $1,200. Most practices will charge by the application or “cycle,” which typically takes an hour. The more cycles you complete in a single day, the lower the price per cycle.
» To learn more about CoolSculpting, read real patients’ testimonials on our forum.
Kybella is a fat-dissolving injectable. It’s currently approved by the FDA for use on the neck to treat double chins. However, many doctors employ off-label uses of Kybella, including treating armpit fat.
Kybella is performed using a series of injections over several appointments. How many injections you receive in a single treatment session depends on the size of the treated area and the amount of fat.
While one treatment session may be enough, most people should expect to return. In fact, it may take up to six sessions for optimal results.
Expect some swelling in the first couple of days. You may also experience some pain, numbness, bruising, and firmness around the injection site. These side effects are minor and will go away on their own.
Don’t expect to see results right away. Kybella is a synthetic version of deoxycholic acid — it dissolves fat cells over time. As with CoolSculpting, these fat cells are metabolized by the body over a matter of weeks.
Risks and Complications
As mentioned above, Kybella is only approved by the FDA for use on the chin. Limited research has been performed into its long term safety in other areas of the body. Still, many doctors attest to the effectiveness of the practice.
Serious side effects include weakened muscles, difficulty swallowing, and nerve injury. If not properly administered, Kybella is also said to kill other kinds of cells, including skin cells.
If a significant amount of fat is lost, you may be left with loose skin and also require tissue tightening treatments.
A single Kybella treatment can cost between $1,200 and $1,800 dollars. If you go in for a few treatments, a likely scenario, you could be looking at $3,600 to $5,400. Of course, this all depends on the number of injections you get per treatment.
» Learn more about Kybella by starting an online consultation with a cosmetic doctor near you.
- American Society for Aesthetic Plastic Surgery: Upper Arm Lift (n.d.) smartbeautyguide.com/procedures/body/upper-arm-lift
- American Society of Plastic Surgeons: Arm Lift (n.d.) plasticsurgery.org/cosmetic-procedures/arm-lift/cost
- Delayed Onset Pain Associated with Cryolipolysis Treatment: A Retrospective Study with Treatment Recommendations (2015) ncbi.nlm.nih.gov/pubmed/26445290
- Removal of Accessory Breasts: A Novel Tumescent Liposuction Approach (2009) ncbi.nlm.nih.gov/pubmed/19488809