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Sweat stains – a thing of the past
Treatment of hyperhidrosis
Suction curettage is a new form of treatment for excessive perspiration in the armpit area (hyperhidrosis axillaris). It has only been performed for a few years in Germany at individual treatment centers. As the name implies, this operative procedure involves a combination of a curettage and liposuction technique. The target organs are the perspiratory glands in the deep dermis or the fibers of the autonomic nervous system which lead to them. The tissue beneath the dermis is vacuumed out, along with the aforementioned structures of the armpit it contains.
Goal of the operation:
The objective of the treatment is to normalize perspiration. We consider this to have been achieved if the patients only perspire moderately afterward, as would people without hyperhidrosis. In ideal cases, patients will remain completely dry after the treatment, even under physical or emotional stress.
In our view, the suction curettage with a suitable operation technique is currently the best compromise between the perspiration improvement that can be achieved, the sustainability of the therapy’s success and the potential complications for the patient. Although the procedure as such is relatively unproblematic in the hands of an experienced surgeon, the treatment’s success depends on the details of the operative technique.
OP procedure:
The suction curettage can be performed as a minimally invasive procedure through the use of the Klein tumescent technique; general anesthesia or an inpatient stay is normally not necessary.
You should take a shower on the morning before the operation and shave your armpits on the day before the operation.
A test of the perspiratory glands is conducted prior to the operation and the area of sweat formation is sketched. Once the skin has been disinfected and a sterile cover has been applied, small welts are made at 3-4 locations under local anesthetic.
After a small incision of the skin at points, a thin filling cannula is inserted into the subcutaneous fatty tissue and the tumescent solution is injected.
After a reaction time of 30 minutes, the bottom side of the skin is painlessly vacuumed off by means of a special suction cannula.
After the operation:
A compressive, absorbent pressure bandage is applied after the treatment. It must be worn for one to two days and the absorbent material must be changed regularly.
Sport activities should be refrained from for 4-6 weeks.
Potential complications:
Wound healing disorders are rare due to the small size of the incisions. But any potential postoperative complications are theoretically conceivable. Empirically, though, the only ones that take place are swellings, hematomas, occasional reddening at the skin incision area as well as a prolonged feeling of numbness in the skin in the armpit area. Isolated instances of skin damage may occur due to the radical approach on the bottom side of the dermis. If this takes place, however, it is usually nothing more than a scab which falls off after a few days. For this reason, though, we inform the patients of the occurrence of skin necrosis.
In very rare cases, the prilocaine which the tumescent solution contains can penetrate through the soft parts of the armpit on into the plexus brachialis area. Should this be the case, it is possible that a temporary feeling of numbness may occur in the area of distribution of the plexus brachialis.
Summary:
The suction curettage is currently the most effective operative procedure for treating primary hyperhidrosis. In comparison with earlier operative procedures, the impairment to the patient is considerably less. The patient can already return to work after a few days, assuming that the activity is not too physically demanding.
A decisive factor for the success of treatment with this procedure is the sufficient radicality of the suction and curettage at the bottom surface of the dermis.
In the delicate balance between the success of the operation and the threat of skin necrosis, we consider it a justified recommendation to have these interventions performed by a specialist.
A brief overview:
- Anesthesia: tumescent technique- suction under local anesthetic
- Inpatient stay at the clinic: no inpatient stay at the clinic
- Follow-up check-up: regularly for up to one year
- Compression girdle: not necessary
- Scar formation: hardly any scars are formed, since only a few small punctures are necessary.
- Work ability: after 2-4 days
- Costs: € 2,100.00, potential cost assumption by private health insurance
- Exercise: no strenuous exercise for 2 months