A new treatment for excessive sweating in the armpit area (hyperhidrosis axillaris) is the “suction-curretage.” It is only in recent years that it has been performed at some special medical-aesthetic centers.

 

Length of surgery: 2 – 3 hours
Type of anesthesia: Local anesthesia
Hospital stay: Not necessary / outpatient
After surgery: Intense recovery period of 2 weeks, sports & strenuous physical activities after 4 – 6 weeks

 

As the name itself suggest, the surgical procedure refers to a combination of curettage and liposuction. Targeted organs 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-suctioning the tissue underneath the dermis with the above mentioned structures of the armpit.

The minimum goal is to normalize the sweating.

In our opinion, this could be considered achieved if, after the surgical procedure, patients sweat under the same circumstances and the same quantities as normal people without hyperhidrosis. In extreme cases, patients don’t even sweat under physical or mental stress.

The “suction curettage” with its corresponding operation technique is, from our point of view, the best compromise between the intended improvement of sweating, the size of the generated scars, the durability 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 performed with the “tumescent procedure” according to Klein with general anesthesia or a hospital stay not being absolutely necessary.

Patients should take a shower on the night and in the morning before the surgery. They should also shave their armpits.

Small cannulas are inserted under local anesthesia into 3 to 4 spots. After a tiny incision into the skin in these spots, a normal cannula for liposuction is introduced into the hypodermis and the corresponding solution injected.

After a reaction time of 30 minutes, the suction cannula is inserted and the liquid is suctioned up.

Following the treatment, an absorbent compression bandage is applied which has to be worn for one or two days and the absorbent material changed regularly.

The wearing of a tight garment underneath the normal clothing is generally sufficient to prevent a serum formation (e. g. breathable sportswear, aerobic or spinning shirt). Physical activities should be avoided for 4 to 6 weeks.

 

Possible complications:

Due to the tiny size of the incisions, wound healing disorders are very rare. Theoretically, all post-operative complications are possible. Experience has shown, however, that only swellings, bruising, occasional reddening in the area of the incisions, as well as a certain numbness of the skin in the armpit area occur.

Due to the radical intervention underneath the dermis, occasional skin damage can occur. If this occurs, it is usually only a scab that falls off after a few days. That is why we inform our patients about the occurrence of skin necrosis.

The lidocaine in the tumescent solution can, in very rare cases, spread over the soft parts of the armpit up to the plexus brachialis. If this happens, temporary signs of paralysis in the area of the plexus brachialis may occur.

Summary:

The suction-curettage is currently the most effective and sensible surgical procedure to treat primary hyperhidrosis. The post-operative complications are considerably less significant than those associated with former procedures. For jobs which do not involve strenuous physical activity, a return to your workplace is already possible after very few days. Decisive for the success of the therapy is that the suction and curettage on the lower side of the dermis are carried out in a sufficiently radical manner. In order to minimize the risks, such as the risk of skin necrosis, and to ensure the success of the operation, we recommend to perform this type of procedure at a specialized center.