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In this episode of the podcast, Dr. Sam Fuller and Dr. Dan Butz take on one of the most commonly discussed yet poorly explained concerns women bring up in consultation: the area of fullness along the outer breast near the armpit, affectionately and infamously nicknamed the “chicken nugget.” It is the spot that peeks out of bras, resists workouts, and often surprises patients who thought breast surgery would magically make it disappear. With a mix of surgical insight and candid conversation, the doctors unpack what this area really is and how best to treat it.

The episode begins with anatomy. Drs. Fuller and Butz explain that lateral breast fullness is not a flaw or a mistake. It is often a normal extension of breast tissue called the axillary tail, sometimes combined with subcutaneous fat. This matters because not all “nuggets” are created equal. Some are primarily fatty, soft, and responsive to contouring. Others contain true glandular breast tissue that behaves very differently than fat and will not reliably shrink with weight loss, exercise, or nonsurgical treatments. Understanding what lives in that space is the foundation for choosing the right solution.

From there, the discussion moves into treatment options, starting with liposuction. Liposuction can be an excellent choice when the lateral fullness is mostly fat. It is minimally invasive, uses small incisions, and allows for smooth contouring that blends nicely into the side of the breast and chest wall. Recovery is typically quicker, swelling settles over weeks, and scars are usually discreet. However, liposuction has limitations. It cannot effectively remove dense glandular breast tissue, and aggressive suction in this area carries risks such as contour irregularities, tethering, or skin laxity if not done thoughtfully. As Dr. Fuller emphasizes, liposuction works best when anatomy and expectations are aligned.

The conversation then shifts to direct excision. For patients whose “chicken nugget” is primarily breast tissue rather than fat, surgical excision may be the more definitive option. This approach physically removes the tissue rather than relying on suction, making it more predictable for dense or fibrous areas. The tradeoff is a scar, usually placed strategically in the natural crease of the armpit. Dr. Butz explains that while many patients are initially scar-averse, they are often more satisfied long-term with a flat contour and permanent result than with incomplete improvement from liposuction alone. Excision also allows for pathology evaluation when appropriate, adding an extra layer of reassurance.

Drs. Fuller and Butz spend time comparing the pros and cons of each approach, emphasizing that there is no one-size-fits-all solution. Liposuction offers smaller scars and faster recovery but may under-treat true breast tissue. Excision offers completeness and durability but comes with a visible incision and slightly longer healing. In some cases, a hybrid approach may even be considered. The key, they stress, is individualized planning and honest preoperative discussion.

This episode is equal parts education and empowerment. Whether you are considering breast surgery, have already had a procedure, or have simply wondered why that area never seems to cooperate, this conversation sheds light on a common problem and the thoughtful surgical strategies available to address it.