Surgical treatment of axillary osmidrosis

Various types of surgical procedures have been developed for treatment of axillary hyperhidrosis and osmidrosis. However, Asian people tend to seek treatment for osmidrosis rather than hyperhidrosis. In this article, we report a new modified surgical method concerning axillary osmidrosis. At first we make four transverse parallel incisions; two incisions in the center are large (approximately 4 cm in length) and the lateral ones are small (approximately 1.5 cm in length). Then, we do enough undermining from the four wound edges to make a wide subcutaneous tunnel, and the adipose tissue beneath the skin is removed with scissors through each incision. Finally, two pieces of Penrose drain are inserted through the small lateral incisions. With this method we have operated on 21 patients in the past 3 years; 19 patients were female, and only 2 were male. Patients were followed for a minimum of 3 months and a maximum of 22 months, with an average follow-up of 7 months. In terms of results, 14 were good, 5 fair, and 2 poor. Minor complications such as partial epidermal necrosis occurred in only 2 patients, but healed with conservative treatment, and other complications such as hematoma formation or infection did not occur. In this article, we emphasize two merits of our procedure. One is that adding small incisions at both lateral margins makes it possible to perform the further excision of the apocrine glands. The other merit is that drainage from the small incisions is very effective. We believe this procedure is a viable option for treatment of axillary hyperhidrosis and osmidrosis.