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Bromhidrosis surgery

Stop Underarm Odor/ Minimally Invasive Rotating Shaver Bromhidrosis Surgery

What is bromhidrosis?

Bromhidrosis, commonly known as underarm odor, is the unpleasant armpit smells. It does not hamper one's health but it is a resource of extreme embarrassment to the individual and has negative impact on social interaction.

Some people consider axillary hyperhidrosis to be equal to bromhidrosis but they are actually not the same. Bromhidrosis refers to the unpleasant odor arising from secretions of apocrine gland, a type of special sweat gland that can be found in the armpits. The apocrine glands become active in adolescence. The thick, odorless, milky sweat produced by apocrine glands gains its characteristic odor (i.e. underarm odor) upon bacterial decomposition and can cause stains on the clothes.

With the constant innovation in cosmetic medical devices, laser has also been applied to treat underarm odor, such as 1,064 nm Nd:YAG laser therapy. During the laser treatment, the hair-bearing area of the axilla is shaved and the apocrine glands at the target area are destroyed by irradiating laser using a fiber probe via needle puncture sites. With the DCD cooling system integrated in the laser system, injury to the epidermis and hair follicles is minimized to prevent post-inflammatory hyperpigmentation.

Comparison of Rotating Shaver Surgery and Laser Therapy for Bromhidrosis Treatment

Minimally Invasive Rotating Shaver Bromhidrosis Surgery

Minimally Invasive Rotating Shaver Bromhidrosis Surgery is an innovative technique evolved from suction-curettage technique. Orthopedic cartilage shaver has been recently applied in the surgical procedure showing merits of smaller surgical wound, faster recovery and better outcome, thus is becoming more popular. This is particularly favored by young female patients, as the tiny surgical wound is barely noticed when wearing swimsuits or sleeveless tops.

The above is purely a case description, and the actual situation will vary from person to person.

In addition to surgery and laser, botox is an alternative to treat bromhidrosis. Botox that has been applied to treat a wide array of medical conditions works by blocking the release of acetylcholine from nerve cells and acetylcholine is the primary neurotransmitter responsible for sweat secretion. Botox injection blocks the nerve impulses to sweat, resulting in less underarm sweating and subsequent less armpit odor comes from bacterial degradation of sweat.

It usually takes 3-7 days to notice the effects of botox treatment for palmar hyperhidrosis, axillary hyperhidrosis and bromhidrosis. The effect will last for 4-6 months. For patients who suffer from excessive sweat or body odor only during summer time, once per year botox treatment is recommended. Otherwise twice per year botox injection is recommended for those who suffer from the symptoms all year long. Although botox's effect wears off with time, it is an easy and fast treatment option that suits for patients who have great concerns about surgical complications, or who underwent axillary surgery but sweating problem remains.

The surgery is performed under local anesthesia, which lasts approx. 40 minutes.

  1. Why apply tie-over bandage on the wound after surgery?
    During the surgery, the skin at axilla area is detached from the subcutaneous tissue to facilitate the damage of apocrine glands by rotating shaver. After the surgery, the skin flap should be re-adhered back to the underlying muscle for healing. However axilla is difficult to dress bandage because movement is required at the shoulder. Therefore tie-over bandage is applied for 5-7 days to provide external pressure at axilla to obliterate dead space and allow healing of the skin flap.

  2. Why hematoma is a major complication of bromhidrosis surgery?
    hematoma can occur after bromhidrosis surgery from localized collection of blood or exudate produced by the injured tissues that is beyond body absorption function.
    Hematoma may lead to infection and skin ulceration. Therefore it is very important to follow the postoperative wound care instructions to prevent hematoma, particularly within the first 2 weeks after surgery.

  3. Will bromhidrosis surgery cause compensatory hyperhidrosis?
    Compensatory hyperhidrosis is a well-known side effect after sympathectomy performed by neurosurgeons to treat palmar hyperhidrosis. Modern bromhidrosis surgery does not cause compensatory hyperhidrosis.

  4. When is bromhidrosis surgery appropriate for teenagers?
    It is recommended that bromhidrosis surgery should be performed on young patients when they have finished puberty; otherwise there is a chance of relapse. However if the body odor has severely affected one's social relation and mental health, we still suggest the adolescent patients receive surgical treatment. Thus even the bromhidrosis relapses after surgery, the symptoms are milder.

  5. What are the limitations of rotating shaver bromhidrosis surgery?
    Rotating shaver bromhidrosis surgery requires great skills and knowledge about the suction and rotation functions of the shaver system by the surgeons to reduce the risk of dermis injury, skin rupture and incomplete apocrine gland removal. Besides, temporary hyperpigmentation at the surgical site may happen that usually takes 6-12 months to fade away.

  6. Who are suitable candidates for rotating shaver bromhidrosis surgery?
    Only patients with coagulation disorders are not recommended to undergo rotating shaver bromhidrosis surgery.

  1. Do not ride a motorcycle or drive home after surgery (for patients who received eye or sleep anesthesia).
  2. Avoid strenuous exercise and do not lift heavy objects within two days after operation to avoid blood vessel rupture and swelling.    
  3. Do not remove the bandages or fixing device yourself.    
  4. Apply ice compression on the first 2 days (48 hours) after the surgery, and from the third day on, apply warm compression until the swelling is gone (please pay attention to the temperature of warm compression to avoid burns).    
  5. Take medication on time for 4 times a day (after meals and before sleep). If the pain is severe, take painkillers once every 3 hours.    
  6. Wound care: Use saline solution and cotton swabs to clean the wounds, wipe dry, and then apply the ointment every morning and evening.    
  7. Don't let the wound contact with water within 2 days after the surgery. From the third day on, use clean water to clean the wound. Do not use cleaner within 7 days after surgery to avoid irritation.
  8. Do not smoke, drink alcohol, tea or coffee, or have pepper and other irritating food within a week after the surgery to avoid affecting the postoperative wound from healing.    
  9. No seafood during the first week after the surgery to avoid allergies (except for fresh fishes).


Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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