Axillary lift

[Alpha90210]

This is my last question (hopefully).

My surgeon seems to routinely do an axillary lift procedure. He removes skin directly from the axilla and combines it with nipple lifts - not sure if its a donut or crescenteric.

Why do I not see anyone else performing this procedure?

Most of my remaining excess skin is in the axilla. Do second stage donut lifts deal with the axillary skin?

I am pending a revision and based on my funds (and since his revision is free), he may be my only option.

[Litlriki]

Peri-areolar (donut) lifts don't address axillary skin.  I'm not what the surgeon is doing from your description of the "axillary lift" and I'd have to see photos to determine if its impact on your situation. 

[Alpha90210]

My understandinv is that he makes a direct excision of the skin in the lateral chest wall starting from the axilla.
https://doctorlib.info/surgery/plastic/plastic.files/image849.jpg

[Dr. Elliot Jacobs]

I think the problem is one of terminology.  When I looked at your recommended URL, this is not a "lift" in the true sense.  I take a "lift" as meaning that something is "lifted up."  That is not true from this diagram.  I have used this type of tightening on a few cases of massive weight loss where there is major skin laxity everywhere.  It is part of what is termed an "upper body lift." This type of incision will "tighten" skin horizontally, not vertically.  And, it will leave a long and rather ugly scar running vertically downwards from the armpit.

Not sure if this is what you would want or whether it is applicable in your case.  Either way, I would only use this approach in extreme cases.

Dr Jacobs

[Litlriki]

In weight loss patients, where the bigger problem with their chest is skin excess, I will often perform a procedure that creates a scar in the infra-mammary fold extending to the axilla, attempting to keep the scar within the fold and slightly hidden by the prominence of the pectoralis muscle.  This has been described as a "double incision mastectomy" (when done as part of the female to male gender reassignment surgery), leaving the infra-mammary scar and a peri-areolar scar.  This can be very effective, but the scar is significant and would only be used where skin excess and laxity is a major issue. Peri-areolar (donut) skin removal is for milder laxity and excess, which is more circumferential than horizontal. 

[Alpha90210]

Thanks for the responses.

[Alpha90210]

So just to clarify. If your excess skin is only in the axilla, the only way to deal with it is to remove all the skin on your chest and leave a large scar on the front of the chest? (inframammary fold)

Trying to figure that out because I would much rather a scar in my axilla than on the front of my chest.

[Dr. Schuster]

It sounds to me that there are a few different interpretations of what's going on here. Without an exam or photos I cannot tell exactly what your problem is and therefore cannot offer any meaningful advise. Operations for weight loss patients, where there is a lot of redundant skin are very different than routine, or even advnced gynecomastia surgery. What you are decribing as axillary skin might not really be in the axilla to a surgeon. Take this in mind when considering advise here. Good luck.