Treatment of Axillary Osmidrosis with the Use of Suction-Assisted Cartilage Shaver

Background:Axillary osmidrosis is an embarrassing condition that causes disturbing social problems, especially in Asian societies. However, topical treatment could only provide temporary improvement. Permanent solutions required surgical intervention. The conventional operation has some disadvantages, such as large wounds, conspicuous scars and long recovery time. The ideal operation should comprehend permanent effect, an outpatient surgery with local anesthesia, short operation time, rapid recovery, minimized complications and inconspicuous scar. The use of suction-assisted cartilage shaver accomplishes all these needs and is already a prevalent treatment of axillary osmidrosis. However, small wound complications still occur postoperatively.Aim and Objectives:We modified the procedure in dissecting the axillary area in order to diminish such complications mentioned.Materials and Methods:From July 2003 to August 2011, 76 patients with axillary osmidrosis (57 females and 19 males) were treated under suction-assisted cartilage shaver with modified procedure. We tunneled the subcutaneous layer above the deep fascia and kept several septa attaching to the skin without completely dissecting the subcutaneous layer. Finally, the complete removal of the apocrine gland was checked by endoscope.Results:All patients were followed up but only 55 patients completed the questionnaire. Patients were followed 2~67 months with an average of 27 months. The satisfaction of malodor improvement was scored from 1~5 (5 indicates very satisfied and 1 indicates disappointed). No odor: 30.9%, almost complete odor elimination: 41.8%, partial odor elimination: 16.4%).One (1.8%) revealed hematoma over right axilla.Conclusion:The modified design of preserving septa without full dissection and endoscopy viewing were used in order to diminish the complications and complete eradication of the apocrine glands.