24.0: Thursday, March 17, 2005

Redundant axillay skin

R. Gil Altman, MD

This is a case report of a 56-year-old female evaluated for “excess skin” of the axilla. She stated that she has always had a protrusion of skin from under her arms. When going through puberty it appeared as if she had four breasts.


Upon evaluation there is protrusion of skin from the axilla, however when the patient flexes her pectoralis muscle this skin retracts back into the axilla. It is the contention of these authors that this represents a herniation of clavipectoral fascia from the axilla.

Upon exploration there was a laxity of the underlying fascia. The fascia was secured to the periosteum of the underlying rib, and the redundancy was gone. The skin was closed primarily without any excision and the hernia was corrected.

1.The clavipectoral fascia surrounds the pectoralis minor muscle; it is a thin sheet of fibrous tissue that runs from the clavicle superiorly to the axillary fascia inferiorly. The connection of the clavipectoral fascia with the clavicle supports and suspends the floor of the axilla, composed of axillary fascia and skin.