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Radical Excision

This is the standard surgery to treat osmidrosis. A 3–4-cm incision is made at the armpit crease, and the skin and subcutaneous tissues are dissected at the area distributed with armpit hair. Then, aggregated particles of the apocrine glands, fats, and partial hair follicles are completely removed from the back of the skin (en bloc excision). The advantages are as follows: able to confirm no residue of the apocrine gland, the highest clearance rate of bad odor at approximately 95%, and the extremely low recurrence rate. Thus, it is applicable for patients with severe osmidrosis or those who heavily sweat due to exercises and work. The disadvantage is the relatively slow recovery of the surgical wound that leads to poor healing, skin flap necrosis, or subcutaneous hematoma and leaves visible scars in the future.

Surgical conditions

Duration

0.5hr
  • Type of anesthesia: IV sedation + local anesthesia
  • Type of incision: A 3–4-cm incision at the armpit
  • Recovery: 7–10 days
  • Removal of stitches: 10–14 days

General instructions

No food and water on the day of surgery

0hr
  • Do not work or perform activities that require raising of the arms for 1 week postoperatively.
  • Avoid strenuous activities that may cause sweating for 1 month postoperatively.
  • Avoid smoking, alcohol, and various irritating and spicy foods for 3 months postoperatively.
  • Take care of the scar consistently for 6 months postoperatively.

Ideal candidates

  • Those with a severe bad odor due to osmidrosis
  • Patients with osmidrosis that makes them feel pressurized or anxious, thus affecting their self-confidence
  • Those with bad odor resulting in social or interpersonal disturbance
  • Those frequently with yellow sweat stained armpits that affect clothing esthetics

Possible complications

  • Scar proliferation
  • Skin pigmentation (temporary)
  • Poor wound healing
  • Hematoma
  • Skin flap necrosis
  • Bad odor recurrence

Surgical advantages

  1. It permanently and radically resolves armpit bad odor for the long term.

  2. Sweat secretion and hair number are simultaneously reduced.

  3. It completely improves armpit sweat stains.

Surgical drawbacks

  1. Surgical recovery is relatively long.

  2. The surgery may leave a scar.

  3. It may cause temporary skin darkening or armpit pigmentation.

  4. The armpit scar may show adhesion or hypertrophy which would be noticed.

Possible procedure in conjunction