A new osmidrosis procedure, the scrape and suction technique: review of 4,322 patients.
BACKGROUND
Axillary osmidrosis causes unpleasant odors and profuse sweating, resulting in social and psychological problems. Many treatment modalities have been attempted and liposuction is preferred because of the minimal scar, although the problem of a high recurrence rate still exists. The aim of this study was to introduce and evaluate the efficacy of a new technique to treat axillary osmidrosis using a liposuction machine.


METHODS
From January 2002 to December 2012, a total of 4,322 patients with axillary osmidrosis were treated with a new technique that combines suction with aggressive scraping. Treatment outcomes were assessed by a patient survey in the outpatient clinic at least 6 months after surgery. Permanent tissue biopsies were obtained from the left axilla before surgery and from the right axilla after surgery and compared to each other.


RESULTS
Ninety-five percent of the patients (n=4,092) were very satisfied with the result, including the postoperative scars, and responded that they never or hardly ever experienced symptoms of axillary osmidrosis postoperatively. Recurrences occurred in 230 patients (5%) and most resolved after additional procedures, except 36 cases (0.8%). The tissue biopsy showed complete excision of the apocrine glands and a well-cut cross-sectional view of the dermis. Superficial epidermal necrosis occurred in 41 patients, probably due to hematoma, and 32 patients of the 41 (78.0%) were treated successfully without any revisional procedures.


CONCLUSIONS
The new technique of scraping and suctioning with a newly designed liposuction machine achieved minimal scars, low recurrence rates, and very high patient satisfaction. This technique can be a simple and effective treatment modality for the treatment of axillary osmidrosis.


METHODS
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Seoul Plastic Surgery Center, Seoul, South Korea, seoul@seoulps.com.
Hun-Gon
HG
Kim
D000293:Adolescent; D000328:Adult; D001050:Apocrine Glands / Q000473:pathology / Q000601:surgery*; D001365:Axilla; D001707:Biopsy, Needle; D002921:Cicatrix / Q000517:prevention & control; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003475:Curettage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000175:diagnosis / Q000601:surgery*; D007150:Immunohistochemistry; D015187:Lipectomy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013396:Suction / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult