Treatment of bilateral axillary hyperhidrosis by suction-assisted lipolysis technique

Axillary hyperhidrosis, although not life-threatening, is a troublesome condition which produces a personal and social handicap of great significance to patients for many years before they seek a cure. Treatment has consisted of application of topical antiperspirants, systemic anticholinergic medications, excision and primary closure of the involved axillary skin, subdermal shaving of the subcutaneous fat pad containing the hypersecreting sweat glands, and combinations of all of the above. Medical treatment is frequently inadequate and surgical techniques so far described may carry significant morbidity. We have used the technique of suction-assisted lipolysis as an alternative method of treatment for this condition. The procedure has been employed successfully in one patient with no recurrence after one year of follow-up. The operation is done as an outpatient procedure under general or local anesthesia. Suction is carried out through a 1-cm incision in the anterior axillary fold and the entire surface of the dermis is fully "vacuumed" in all directions with 15 to 20 strokes, using a 5- or 7-mm diameter cannula. The area treated includes the area of maximal axillary hair growth and 5 to 6 cm beyond. Routine dressings are removed five days posteroperatively, with the patient generally resuming all activities within one week.