History: The patient was a young woman, 28 years old and unmarried. She came to the clinic with “bilateral axillary odor for more than 10 years”. The patient developed bilateral axillary sweating with odor 13 years ago with no obvious cause, no obvious redness, swelling, heat and pain, and no limitation of movement of both upper limbs. The patient had been treated with medication without obvious effect, and then the odor gradually worsened with age, which affected her study and work, and now she was admitted to our outpatient clinic for “bilateral axillary hyperhidrosis”. The patient received several treatments over the past 10 years, specifically: 8 years ago, she received bilateral axillary injections, and after the operation, she underwent scar excision on the right side + axillary sweat gland scraping 5 years ago. After the operation, a right axillary abscess appeared, and the wound healed after several dressing changes. However, the odor still existed. He was usually physically fit, with no history of hypertension, no history of coronary heart, diabetes mellitus, or chronic branch. Physical examination: sparse axillary hair in the bilateral axillary hair area, visible scar contracture with odor, no redness, swelling, heat and pain, no skin breakdown, no enlargement of superficial lymph nodes throughout the body, limited lifting of the right bilateral upper limbs, no obstruction to the movement of the left upper limbs. Auxiliary examination: blood routine, coagulation function were normal. Diagnosis: Bilateral axillary hyperhidrosis (axillary odor) Diagnosis: After diagnosing and perfecting the preoperative examination, “bilateral axillary hyperhidrosis” was performed under local anesthesia, and the operation went smoothly and the patient was discharged on the same day. 【Treatment analysis】 The patient was a patient with a long history of recurrent axillary odor. The patient was troubled by the disease for a long time, and first tried axillary drug injection treatment (the specific drug is not known), the basic principle of this treatment is to destroy the axillary sweat glands through drugs. However, recurrence occurred less than six months after the procedure. The patient then decided to treat again, this time with axillary sweat gland scraping, but the recurrence continued after surgery. At the same time, the excision of the original scar tissue caused an infection in the axilla, forming an abscess, which not only affected the wound healing, but also caused a time bomb of residual infection, which could reoccur at any time. The wound healed after a long dressing change, but the movement of the right upper limb was affected. From personal experience, we can say that the consequences of these two treatments are related. First of all, both treatments are minimally invasive under blind vision, which has the advantage of minimal trauma and quick recovery; the disadvantage is that it is impossible or difficult to achieve a radical cure. The disadvantage is that it is not possible or difficult to achieve a cure because it is not possible to see the extent of the sweat glands and their development under blind vision. In addition, the destruction of the hair follicles caused by the first treatment and the scar contracture lay the groundwork for the failure of the second treatment. Because the level of the axillary sweat glands had been destroyed after the first treatment, there were residual or hyperplastic sweat glands mixed in the dense scar tissue that were no longer at the level of the superficial subdermal fascia, so the use of blind scraping again inevitably led to incomplete removal of the sweat glands. The 3cm incision healed smoothly without increasing the chance of flap necrosis or infection. The patient’s problem was completely solved, and the treatment of axillary odor was brought to a perfect end on the patient’s long road to medical care. The first time you have to go through the process of getting a new one, you’ll be able to get a new one. The traditional flap excision was the mainstream treatment, which is the complete removal of sweat glands and their flaps to achieve the purpose of radical treatment. However, the flap excision is invasive, the scar is obvious and affects the activities of the upper limbs; “injection therapy” is mostly through the injection of anhydrous alcohol to destroy the gland to remove the odor, but “blind” operation will often have residual, high recurrence rate after surgery. Nowadays, with the development of technology, there are “golden microneedle”, “nano-positioning ablation”, “waterjet excision” and other treatment methods. There are hundreds of reported treatments for armpit odor, but the people lack understanding of this, the medical market has a wide range of names, the results of the treatment of uneven levels of efficacy often bring great difficulties for follow-up treatment. The principle of axillary odor treatment is the complete removal of the sweat glands in the armpit, and the less sweat glands remain, the less likely it is that odor will exist after surgery. The density and extent of the sweat glands are difficult to define under blind vision. Therefore, surgical removal of the sweat glands under direct vision is still recognized as the most complete treatment today, and as the times have changed, patients need smaller invasions with guaranteed results. Therefore, the problem of how to remove all sweat glands with a small incision is the problem that the surgeon has to solve. Our modified small incision direct vision axillary sweat gland excision with modified surgical approach can hide the incision in the axillary crease, the length of the incision is controlled to 2-3cm, the trauma is small, you can leave the hospital on the same day after the operation, and there is no need to remove stitches after the operation, usually 4-5 days after the operation can resume daily work. The scar after surgery is hidden and does not affect young women wearing camisoles, tank tops and other sleeveless tops, and more importantly, they are free from the dependence on drugs. This procedure provides the best surgical results while maintaining the aesthetic appearance of the wound and has benefited a large number of patients over the years.