Axillary fat pad removal is a specialised cosmetic procedure designed to remove excess fat from the armpit area, resulting in a smoother and more defined contour. This surgery is minimally invasive and can significantly improve the aesthetic appearance of the underarm region, enhancing comfort and confidence, especially when wearing sleeveless or tight-fitting clothing.

1. Consultation and Pre-Operative Assessment

The first step in the axillary fat pad removal process is a detailed consultation with a certified plastic or cosmetic surgeon. During this session, the surgeon will assess the amount of excess fat, discuss the patient’s expectations, and determine if they are a good candidate for the procedure.

Pre-operative instructions are given, including:

• Stopping certain medications, such as blood thinners or anti-inflammatory drugs, that may increase the risk of bleeding.
• Avoiding smoking and alcohol before surgery to promote better healing.
• Fasting for a few hours before surgery if general anesthesia is used.

2. Anesthesia

The axillary fat pad removal surgery is typically performed under local or general anesthesia, depending on the patient’s preference and the extent of the procedure.

• Local Anesthesia: This is commonly used when a small amount of fat needs to be removed. It numbs the specific area, allowing the patient to remain awake but pain-free during the surgery.
• General Anesthesia: This may be administered if a larger volume of fat is being removed or if the patient prefers to be fully sedated during the operation.

The anesthesia type will be discussed during the pre-operative consultation, ensuring the patient’s comfort throughout the procedure.

3. Marking the Incision Sites

Before beginning the surgery, the surgeon will mark the axillary area with a surgical pen to outline the regions where fat is to be removed. These markings help guide the surgeon to target the precise location of the axillary fat pad, ensuring symmetry and optimal results. Typically, small incisions are placed strategically in areas that are naturally concealed, like the folds of the armpit, to minimize visible scarring.

4. Incision and Fat Removal

Once the anesthesia has taken effect, the actual surgery begins. Small incisions, about 2-3 millimeters in length, are made near the axillary region. Through these incisions, a thin, hollow tube called a cannula is inserted to break up and suction out the excess fat. The most common technique used for axillary fat pad removal is liposuction, which allows for precise fat removal with minimal disruption to the surrounding tissues.

• Liposuction Technique: The surgeon moves the cannula back and forth beneath the skin to break apart the fat deposits, which are then suctioned out using a vacuum device. The goal is to remove enough fat to smooth out the bulging axillary area while preserving a natural, aesthetically pleasing contour.
• Tumescent Liposuction: In some cases, a tumescent solution (a mixture of saline, epinephrine, and lidocaine) is injected into the area before the fat is removed. This solution helps to numb the area, reduce bleeding, and make fat easier to extract.

The amount of fat removed varies depending on the patient’s needs, but the surgeon ensures a balanced and even outcome on both sides of the body.

5. Closing the Incisions

After the fat has been removed, the incisions are carefully closed with sutures or surgical glue. In some cases, tiny drainage tubes may be placed under the skin to prevent fluid buildup in the treated area. These drains are typically removed a few days after the surgery during a follow-up visit.

The small size of the incisions means that scarring is usually minimal, and over time, they will fade and become less noticeable. The surgeon will ensure that the incisions are placed discreetly within the natural folds of the armpit.

6. Post-Operative Dressing

Once the surgery is complete and the incisions are closed, the axillary area is cleaned, and a bandage or compression garment is applied. Compression garments are essential for helping the skin adhere to the underlying tissue, reducing swelling, and promoting a smooth contour. These garments also support the healing process and minimize discomfort.

The surgeon will provide specific instructions on how long to wear the compression garment, which is usually for a few weeks post-surgery.

7. Recovery and Aftercare

The axillary fat pad removal procedure is typically performed on an outpatient basis, meaning patients can return home on the same day. However, recovery time varies from person to person.

• Initial Recovery (First Week): Patients may experience some swelling, bruising, and discomfort in the armpit area. Pain medication will be prescribed to manage any discomfort. It’s essential to keep the area clean and follow all post-operative care instructions to avoid infection.
• Resumption of Activities: Most patients can return to light activities within a few days. However, any strenuous physical activity, especially those involving the arms and shoulders, should be avoided for at least 4-6 weeks to allow for proper healing.
• Swelling Reduction: Swelling may persist for a few weeks, but patients will notice an improvement in the appearance of the axillary area within 4-6 weeks as the swelling subsides.
• Follow-Up Appointments: Regular follow-up appointments will be scheduled to monitor healing and ensure that there are no complications. The surgeon may remove the sutures (if not absorbable) and drainage tubes (if used) during these visits.

8. Results and Final Outcome

Patients typically start seeing the full results of their axillary fat pad removal procedure within 3-6 months. As the swelling completely disappears, the underarm area becomes more contoured and aesthetically pleasing. The results are generally long-lasting, especially when paired with a healthy lifestyle, including regular exercise and a balanced diet.

While axillary fat pad exercises alone may not be sufficient to remove the fat, maintaining a healthy body weight and toning the surrounding muscles can help sustain the results of the surgery.