Long Term Follow Up of Surgical Treatment of Axillary Osmidrosis and Hyperhidrosis by Instrumental Shaving and Manual Shaving

PURPOSE: Axillary osmidrosis is caused by excessive apocrine gland secretion, which causes an unpleasant odor. Axillary osmidrosis causes difficulty in social activities and personal handicap. We studied the long term follow up results of our surgical procedures and sought to find a best surgical treatment methods. METHODS: From January 1991 to December 2006, a total of 1864 patients(587 men, 1277 women) had been treated with this procedure for axillary osmidrosis and hyperhidrosis. Follow up periods varied from 10 to 15 years. We used the subdermal excision technique, using two small incisions over the axilary folds and using a Kawata dissector(instrumental shaving) and additional manual subdermal excision(manual shaving). RESULTS: Among the total patients, 782 patients were followed up. Except a pure hyperhidrosis patients, 759 osmidrosis patients was included. 588 patients(77.4%) had a good results, 148 patients(19.5%) had a moderate results and 23 patients(3.1%) had a recurrence. Complication developed in 189 patients(10.1%): hematoma or seroma in 25 patients, wound dehiscence in 86 patients, partial skin necrosis in 45 patients, and infection in 28 patients. CONCLUSION: We conclude that our method has several advantages such as 1) short operation time, 2) minimal scaring, 3) lower complication rates, 4) high satisfactory rates.

Experience with Various Scars after Treatment of Axillary Osmidrosis

The goal of osmidrosis operation is not only to be free from odor, but also to leave a minimal operation scar. In practice, however, many patients suffer from unfavorable axillary operation scars. Therefore, we herein report various postoperative axillary scars which we experienced. From January 1991 to December 2006, a total of 270 patients(74 men and 196 women) whose axillary osmidrosis had been treated by various methods more than once were included. We observed pre-existing operation scars of recurred patients who wanted revisional operation. Among the total patients, 118 patients had been treated once, 138 patients less than 5 times, and 14 patients more than 5 times. Previous treatment methods included excision in 216 cases, laser in 188 cases, subdermal excision in 63 cases, ultrasonic liposuction in 25 cases, Kobayashi insulated needles in 29 cases, and botulinum toxin injection in 1 case. We observed irregular scar, wide spread scar, hypertrophic scar, postburn scar, depressed scar, and pigmented scar. Pre-existing operation scars were not improved enough by revisional operation. We propose that it is important to select a proper method to effectively get rid of an axillary odor, leaving a minimal operation scar, because axillary area is not optimal for scar revision.