Patient: Is it effective to treat armpit odor by injecting type A carnitine? How long can I stay odorless? How long does the injection take and do I have to go into the operating room? Our tertiary people’s hospital here can do? The Ninth People’s Hospital of Shanghai Plastic Surgery Department Wang Tao: After the injection, the armpits basically do not sweat and no smell, can be maintained for about six months. The injection will take about twenty minutes and you will have to go into the operating room, so we suggest you come to our Ninth Hospital for the injection. Your hospital there may not necessarily have this relatively new treatment. You’d better come to my clinic first, and I can show you the past injection cases. Patient: Hi doctor, I am mainly inconvenienced at work, is it possible on weekends or holidays? Can I do it if I come to Shanghai in the morning? Do I need to recover after the surgery (for example, I can’t do sports or take a shower), will you do it or someone else, and can I call you if you are not there? Do I have to shave my armpit hair, so that no one can see it? The Ninth Shanghai People’s Hospital Plastic Surgery Department Wang Tao: I know your situation, I am not working on weekends and holidays. But if you make an appointment with me in advance, I can try to help you arrange the surgery. You can do it on the same day you arrive in Shanghai. After the surgery, there is no impact on your activities and life, just be careful not to touch water in the armpit on the same day. You can exercise and take a shower the day after surgery. Patient: Hello doctor, I would like to ask about Botox injection: 1. 2. Do I need to have anesthesia? 3. Are there any side effects? (The Internet said that the grip strength is reduced, painful, etc.) 4, do I need to hang water after the operation? 5.After the injection, will the effect be there? Thank you. Wang Tao, Department of Plastic Surgery, Shanghai Ninth People’s Hospital: Before the injection, the armpit hair should be shaved, but it is better to come to the hospital first, I will help you draw a general area and then the nurse will help you shave it. It is not very painful to play anesthesia, because the injection level is not very deep, there are generally no side effects, no need to hang water after the surgery, the medicine does not have to eat. The effect will be seen in one to two weeks after the injection. Patient: Doctor, I read on the internet that if you play too many times, you will develop antibodies and it will be useless to play again, I don’t know if it is? The first thing you need to do is to get a good idea of how much it will cost (such as whether you want a medical checkup). There is no obvious problem of decreasing effect. So there is no need to worry too much. If you are really worried about your financial ability, you can choose the imported BOTOX Botox, which is more pure and less prone to produce antibodies. Patient: Dr. Wang, thank you for your patience in answering my questions. I would also like to ask, will the sweat in the armpits be gone, but the sweat in other places will be compensated, such as the groin, because I also have a smell here (I don’t know if there is a cure), will it be easier to sweat and become smelly (because I heard that some people have smells in other places of the body after microdermabrasion). What is the principle of Botox? If I make an appointment with you, can I save some time? The Ninth People’s Hospital of Shanghai, Department of Plastic Surgery, Wang Tao: Hello, you are welcome, your question shows your trust in me, let me introduce to you. Botulinum toxin is very effective in inhibiting the secretion of the neurotransmitter acetylcholine by nerve cells, so it can very well inhibit the excitability of the sympathetic nerves that dominate the sweat glands and promote sweat secretion by sweat glands. Our human sweat gland secretion is also controlled by the sympathetic nerve through acetylcholine as a conductive medium. Many patients do not sweat when they are sleeping, resting, relaxing, and other times when the sympathetic nerves are not excited. When they exercise or are stressed (sympathetic excitement), they will sweat. Therefore, local injection of Botox in the armpits can achieve a good effect of anti-sweating, and the odor in the armpits will be removed because the bacteria will no longer decompose and produce odor after no sweating. There is no unsuitable group of people unless they are allergic to the toxin protein, so it is best to observe and rest for 10-20 minutes after the injection before leaving the hospital. The first patients with hyperhidrosis of the hands were treated with ganglion cauterization, which was extensive and not easy to control, resulting in severe and widespread compensatory sweating. Now Botox is taking effect and replacing this procedure. The treatment of hand sweating with Botox focuses on the sweaty areas of the palms, where compensatory sweating is rare. If used on patients with axillary hyperhidrosis and axillary odor, the chance of compensatory sweating is even less. Generally speaking, the effect of treating hand sweating, axillary odor, and axillary hyperhidrosis can appear 3-7 days after Botox injection, and the effect can last for 4-6 months. If a person has this problem in summer, it can be administered once a year, and if the person has this problem all year long, it may need to be injected twice. The sweat glands are present in many parts of the body, except for the bilateral armpits where they are more concentrated and numerous, the perineum, around the anus, around the umbilicus, and around the areola of the nipples where there may be a small amount of sweat glands. The compensatory sweating you mentioned refers to the sweating that occurs after the traditional nerve cautery treatment for hyperhidrosis and does not occur after Botox injections. The secretion of sweat glands in other parts of the body should not be affected after axillary surgery or Botox injection, so there may still be some residual odor in the private parts of the body, but the degree must be greatly reduced compared to before the treatment, and the areas are generally hidden, so if you pay attention to personal hygiene, it will not cause great impact on daily life and work.