Sweat gland removal
A new treatment for the excessive sweating in the area of the armpit (Hyperhydrosis axillaris) is the “suction-currettage”. It is only carried out in some particular medical-aesthetical centers in Germany.
As the name itself indicates, this surgical procedure refers to a combination of curettage and liposuction. Targeted organs here are the sweat glands located in the deeper area of the dermis and the fibers of the nervous system that lead to them. It consists of vacuum-sucking the tissue placed underneath the dermis with the a.m. structures of the armpit.
The minimal purpose of the treatment is to normalize the sweating. In our opinion, this could be considered achieved if, after the intervention, patients sweat in the same circumstances and quantities as normal people without hyperhydrosis do. In extreme cases, patients are completely sweatless even after physical or mental stress.
The „suction-curettage“ with its corresponding operation technique is, in our opinion, the best compromise between the intended improvement of sweating, the magnitude of the generated scars, the lasting of the treatment success and the possible complications for the patient. Even though the procedure as such is relatively unproblematic in the hands of an experienced surgeon, the success of the therapy entirely depends on the operation technique.
Operation technique:
The „suction-curettage“ can be carried out with the „tumescent procedure“ according to Klein, being a general anesthesia or a stationary stay at hospital in general not necessary.
The patients should take a shower on the night and in the morning before the operation. They should also shave their armpits.
On 3 – 4 spots, small cannulas are placed under local anesthesia. After a tiny incision into the skin on these spots, a normal cannula for liposuction is inserted into the hypodermis and the corresponding solution is injected.
After a reaction time of 30 minutes, the suction cannula is inserted and the liquid is sucked up.
Subsequently to the intervention, an absorbent compression bandage is placed. It has to be worn one or two days and the absorbent material has to be changed regularly.
The wearing of a tight piece of cloth underneath the normal clothing helps in general sufficiently to work against a serum formation (for example breathable sportswear, aerobic or spinning shirt). Exercise activities should be avoided for 4 – 6 weeks.
Possible complications:
Due to the very tiny incision made, disorders in the healing of the wound are very rare. Theoretically there are some possible postoperative complications. However, according to the gained experience in the postoperative evolution, only swellings, bruises, occasional reddening on the area of the incisions, as well as a certain numbness of the skin in the armpit area occur.
Due to the radical intervention on the lower side of the dermis, occasional skin lesions can occur. If this occurs, in most cases it is only a scab that falls up after a few days. That is the reason why we inform our patients about the apparition of skin necrosis.
The lidocaine present in the tumenscent solution can, in very rare cases, spread over the soft parts of the armpit up to the plexus brachialis. If it happens, signs of paralysis in the area of the plexus brachialis can occur.
Summary:
The suction-curettage is at present the most reasonable surgical procedure to treat primary hyperhydrosis. The post surgery complications are considerably less significant than those associated to former procedures. For jobs that do not involve exhausting activity, a return to your workplace is already possible after very few days. Decisive for a success of the therapy is the sufficient radicalness of the suction and curettage on the lower side of the dermis. Because of the mentioned tension existing between the desired success and the threatening skin necrosis, we recommend to carry out this kind of interventions in specialized centers.