Original Article By Sarah Kinonen
Real talk: We all probably have something we'd like to change about our appearance. Whether that means getting highlights or a procedure that requires a little more commitment (and money) — for example removing fat between armpit and bra, known as "bra bulge" — then who are we to stand in the way? According to Beverly-Hills-based plastic surgeon and RealSelf contributor Sheila Nazarian, MD, there's been a slow but steady rise in the number of requests for "bra bulge" removal surgery within the last few years from "young, active" women in their twenties, thirties, and sometimes forties.
The procedure is a fat-reduction surgery that can be done one of three ways: via liposuction, CoolSculpting, or Kybella, says Dr. Nazarian. She adds that, in her experience, the most common procedure for this type of treatment is liposuction: It's the oldest and best-known option. During liposuction, which is a one-time treatment, incisions are made in the area of concern and fat cells are vacuumed out with a wand. Then incisions are stitched closed. "Bra bulge" liposuction can be performed under local anesthetic within about an hour or two.
Some patients, meanwhile, opt for CoolSculpting, a noninvasive method for killing fat cells by chilling them. "When fat cells freeze, they die, which reduces some of the bulge," explains Min S. Ahn, MD, a double-board-certified plastic surgeon in Boston. The procedure, which reduces approximately 20 percent of the fullness of the "bulge" during a 35-minute session, involves attachment of a CoolCurve applicator to the area of concern while the patient sits and waits.
"Initially, the treatment feels cold, and after a few minutes, the area just feels numb," says Dr. Ahn. "There is minimal discomfort as the treatment starts, but once it has set in, there is no pain." Following the procedure, the area of skin treated will feel slightly sensitive to touch, but will return to normal within about a half hour. With CoolSculpting, more than one session is typically needed, says Dr. Ahn.
And then there's Kybella, an injectable medicine that dissolves fat, much like a detergent can break down grease, which has picked up steam for this type of fat-removal procedures since its FDA approval two years ago, says Matthew Schulman, MD, board-certified plastic surgeon.
"Kybella can be used on virtually any part of the body, so it is commonly requested for treatment of the neck (double chin), back of the thighs, flanks, inner thighs, or residual fat after liposuction procedures," says Schulman. "In my office, we perform six to ten Kybella treatments per week, and about half are for 'bra bulge' removal." It takes only a few minutes to administer and is injected into areas of unwanted fat with a series of small needle sticks. In the weeks following the injection session, the medicine breaks down fat cells, Schulman explains.
Similar to CoolSculpting, Kybella requires multiple treatments, depending on the amount of fat being targeted, but the average amount of sessions for small- to moderate-sized "bulges" is two to three. For all three treatments, typical side effects include bruising and slight swelling, but these last only a couple of weeks at most, says Dr. Nazarian. As for the cost, all three vary in price, depending on the amount of sessions required to remove the fat. Dr. Ahn says the starting price for liposuction is $3,500, while CoolSculpting typically ranges from $600 to $750 per application, and $700 per vial of Kybella.
Bottom line: No matter which of these options you choose, it's definitely going to be an investment — and before pursuing it, it can't hurt to first make sure you have well-fitting bras.