Surgical treatment of axillary bromhidrosis by combining suction-curettage with subdermal undermining through a miniature incision

The suction-curettage technique has been widely applied in the treatment of axillary bromhidrosis. However, it can only moderately eradicate the malodor. From 2011 to 2013, we performed the suction-curettage procedure alone in 91 patients with primary axillary bromhidrosis (group A). From 2014 to 2016, we refined the suction-curettage technique by performing wide subdermal scissors undermining through a miniature incision in 80 patients (group B). Through a miniature incision at the inferior pole of the central axillary crease, the entire subcutaneous tissues containing apocrine glands were initially dissected with scissors within the axillary area and then the undermined apocrine glands were removed by suction-curettage. In group B, 87.5 percent of axillae (140/160) showed significant malodor eradication postoperatively, which was higher than the 33 percent of axillae (60/182) associated with the group A (p < 0.01). Accordingly, patients in group B had a higher satisfaction about the procedure and life quality improvement (p < 0.01). The overall complication rate for the group B was 13.7 percent, which was significantly higher than the 4.4 percent complication rate in the group A (p < 0.01). By combining the suction-curettage with subdermal undermining through a miniature incision, we could achieve a higher curative effect for primary axillary bromhidrosis in comparison to the suction-curettage technique alone. The complication rate was significantly higher than the suction-curettage alone but the final result was acceptable to the patients.