A Minimally Invasive Procedure for Axillary Osmidrosis: Subcutaneous Curettage Combined with Trimming Through a Small Incision

Though minimally invasive procedures often yield excellent esthetic results for axillary osmidrosis, the high recurrence rates of malodor limit its further application. Incomplete removal of the apocrine glands would lead to recurrence of the axillary bromhidrosis, while excessive resection of the apocrine glands firmly attached to the dermis would easily result in local skin necrosis. Therefore, accurate management of the apocrine glands is extraordinarily important, particularly with a limited access. Herein, we would like to introduce an effective and minimally invasive procedure combining subcutaneous curettage and trimming for the treatment of axillary osmidrosis. A 5-mm incision was marked at the inferior pole of the central axillary crease. Subcutaneous undermining was done clinging to the axillary superficial fascia. The whole procedure was performed in the following sequence of "scraping-trimming-scraping" against the undermined skin flap until the remaining hairs were easily pulled out. All the wounds healed primarily without significant complications. Out of 300 axillae, 294 (98 %) showed good to excellent results for malodor elimination. Scars were invisible in 280 axillae (93.3 %) and slightly visible in 18 axillae (6 %). The dermatology life quality index score decreased significantly after the operation. The procedure is an efficacious and minimally invasive method for the treatment of axillary osmidrosis. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.