Tumescent superficial liposuction with curettage for treatment of axillary bromhidrosis

Backgrounds Axillary bromhidrosis is a common but unpleasant and distressing problem faced by many societies, particularly in Asia, where malodour is reflected as a social handicap. Currently, local surgery is the treatment of choice among various non-surgical and surgical treatment. Objectives To evaluate the clinical efficacy and safety of tumescent superficial liposuction and curettage in treating axillary bromhidrosis. Methods Forty-three patients (25 females and 18 males, average age 24.5 years) have undergone tumescent superficial liposuction and curettage. Local anaesthesia, tumescent solution, was injected into the hair-bearing area of the axilla. Two tiny incisions were made for Fatemi cannule, and subcutaneous tissue was removed by stroke movement under negative pressure. Subsequently, additional curettage was done around the incision sites. We evaluated the clinical efficacy (excellent, good, fair and poor) and complications. In addition, preoperative and postoperative histologic findings were reviewed in 15 patients. Results The follow-up evaluation started 3 months after the surgery, and mean follow-up period was 15.8 months, ranging from 3 to 54 months. Among 43 patients, 31 patients (72.1%) showed excellent to good results. The most common postoperative complication was transient ecchymosis which spontaneously regressed in 1 to 2 weeks. Focal skin necrosis, induration, and haematoma or seroma were each noted in four, three, and one patients, respectively, but resolved after proper dressing. The preoperative histological findings included increase in size and number of apocrine glands in cross-section view, and the postoperative specimen evidently showed removal of subcutaneous tissue, including apocrine and eccrine glands, and remnant sweat glands were severely destructed. Conclusion Tumescent superficial liposuction with curettage for axillary bromhidrosis is an effective and safe treatment method for axillary bromhidrosis.