title: Repeat liposuction-curettage treatment of axillary hyperhidrosis is safe and effective.
abstract: BACKGROUND
  Liposuction-curettage (LC) is an effective surgical therapy option for axillary hyperhidrosis, with less scarring compared with radical excision of axillary skin. Although this method has proven to be effective, the treatment of nonresponders to minimally invasive surgery has not been previously defined. Whether these patients benefit from a second surgical procedure has not been evaluated so far.
  
  
  OBJECTIVE
  To investigate efficacy and side-effects of a second LC with an aggressive rasping cannula in patients with insufficient prior surgery.
  
  
  METHODS
  Nineteen nonresponders to prior LC (13 female and six male) underwent a second LC with a rasping cannula. Gravimetry was performed before and 8 months after surgery. Side-effects, patient satisfaction, the surgeons' intraoperative evaluation and the Vancouver Scar Scale (VSS) before and after surgery were documented.
  
  
  RESULTS
  Sweat rates showed a reduction of 69% in 17 (89%) patients. Two patients (11%) did not respond to surgery. Eighty-four per cent of all patients were completely satisfied or satisfied with postoperative results. No severe side-effects were observed. The surgeon reported slightly increased difficulties during dissection of dermis from subcutaneous fat in three patients. Assessment of scars showed an excellent aesthetic outcome (mean VSS 0.79 before vs. 1.1 after surgery).
  
  
  CONCLUSIONS
  LC using an aggressive cannula is an effective therapy option for patients with insufficient response to prior LC surgery, with a low risk of side-effects.
authors.affiliation: Department of Dermatology and Allergology, Ruhr-University Bochum, Gudrunstrasse 56, 44791 Bochum, Germany. f.bechara@elis-stiftung.de
authors.forename: F G
authors.initials: FG
authors.lastname: Bechara
authors.forename: M
authors.initials: M
authors.lastname: Sand
authors.forename: N S
authors.initials: NS
authors.lastname: Tomi
authors.forename: P
authors.initials: P
authors.lastname: Altmeyer
authors.forename: K
authors.initials: K
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D001365:Axilla / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology; D003475:Curettage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology / Q000601:surgery*; D015187:Lipectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D017060:Patient Satisfaction; D012086:Reoperation / Q000009:adverse effects / Q000379:methods; D013546:Sweating; D016896:Treatment Outcome