Aesthetic Plast Surg. 2009 Jun 2; Fan JBACKGROUND: Accessory breasts, usually with a protuberant appearance, are composed of both the central accessory breast tissue and adjacent fat tissue. They are a palpable convexity and cosmetically unsightly. Consequently, patients often desire cosmetic improvement. The traditional general surgical treatment for accessory breasts is removal of the accessory breast tissue, fat tissue, and covering skin as a whole unit. A rather long ugly scar often is left after this operation. A minimally invasive method frequently used by the plastic surgeon is to "dig out" the accessory breast tissue. A central depression appearance often is left due to the adjacent fat tissue remnant. From the cosmetic point of view, neither a long scar nor a bulge is acceptable. METHODS: A minimal incision is made, and the tumescent liposuction technique is used to aspirate out both the central accessory breast tissue and adjacent fat tissue. If there is an areola or nipple in the accessory breast, either the areola or nipple is excised after liposuction during the same operation. For patients who have too much extra skin in the accessory breast area, a small fusiform incision is made to remove the extra skin after the accessory breast tissue and fat tissue have been aspirated out. RESULTS: From August 2003 to January 2008, 51 patients underwent surgery using the described technique. All were satisfied with their appearance after their initial surgery except for two patients with minimal associated morbidity. CONCLUSIONS: This report describes a new approach for treating accessory breasts that results in minimal scarring and a better appearance than can be achieved with traditional methods.