Surgical treatment of axillary osmidrosis

Immunohistochemical Differentiation and Localization Analysis of Sweat Glands in the Adult Human Axilla

“…However, for successful type I surgery, it is mandatory that the glands at the dermal/subcutaneous interface be resected in a way that only a full-thickness skin graft is left. 12 In this context, it is known that by using superficial blunt liposuction alone it is impossible to eradicate all the sweat glands in the subcutaneous area, 27 as considerable force is needed to disrupt the glands from their ducts. For this reason, Jemec 13 successfully used a sharp curette and resected the glands down to a full-thickness skin graft, and Kim et al 26 recently presented a combined, minimally invasive technique for axillary osmidrosis: subcutaneous tissue removal and carbon dioxide laser application.…”

“…A bewildering multitude of surgical methods has been reported to date, and, among the most important, three classic methods (types I through III) can be identified. 10 Type I removes (i.e., excises, curettes, suctions, or vaporizes) only the subcutaneous tissue and spares the skin [11][12][13] ; type II removes subcutaneous tissue and skin en bloc, mostly in the dome of the axilla 8,14 ; and type III is a combination of type I and II, with removal of subcutaneous tissue and skin en bloc centrally and removing only subcutaneous tissue in the adjacent areas. 4,10,15 Many of these surgical methods are based on the long-standing theory that eccrine glands are localized in the dermis and apocrine glands are localized in the subcutaneous tissue.…”

Upper thoracic sympathectomy for axillary osmidrosis or bromidrosis

“…[2][3][4] A wealth of various surgical techniques have been proposed since early 1960s. These include partial resection of axillary skin and subcutaneous tissue, 6 removal of subcutaneous tissue without removing skin, 5;7;8 shaving procedures, 13 curettage, suction curettage, cryosurgery, and combination of the above methods.…”

“…Different modalities that have been applied to patients include topical or systemic medication, and surgical techniques. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Upper thoracic sympathectomy has been widely used to treat PH and can block the axillary sweating as well. [19][20][21] In comparison with other cutaneous or subcutaneous procedures, upper thoracic sympathectomy may cause less infection of the axillary sweat glands or ducts and may not produce unpleasant scarring after the procedure.…”

Axillary Sweat Gland Excision

“…The abrasive methods, which are outlined in figure 2 [8][9][10][11], use a small incision to remove the subdermal sweat glands and the subcutaneous fat down to the level of the superficial axillary fascia. Attention should be paid to the intercostobrachial nerves.…”