2021/11/23

Treatment method in which a nurse is in charge of armpit pain treatment

Aside, Director's Blog

Reading Time: <1 minuteOf course, armpit surgery is performed by a doctor. However, recently, there have been many problems with nurses treating armpits. Non-surgical armpit treatments include Miradry and Viewhot. Recently, ultrasound treatments such as HIFU have also become available. The common feature of these treatments is that they all use equipment to press a dedicated probe against the affected area and irradiate it. For this reason, the technique is simple and even nurses can perform the treatment. However, nurses have not studied medicine. Even if they study nursing, they are not experts in dermatology, wound healing, or cosmetic medicine. It is not the same whether they are nurses or doctors, as they only press a probe against the skin and irradiate it. First of all, there are individual differences, so detailed parameter settings such as output, irradiation time, and range are required depending on the condition of the skin, the treatment area, etc. of each individual patient, and following the manual given by the company not only does not produce sufficient results, but extremely serious skin damage, burns, and nerve damage have actually occurred as medical accidents. So why do nurses treat armpits? The reasons are assumed to be as follows. 1: The treatment time is long and it is not worth it considering the doctor's fee. 2: The surgery is performed by a doctor, but only nurses are available due to the reservation situation. 3: The company sold the equipment to me, saying that it is a simple treatment that even a nurse can do. 4: Considering how to reduce the cost of treatment in the price war, the business will not be viable unless a nurse performs the treatment. 5: Doctors do not know anything about body odor. For this reason, not only are there risks involved in nurse treatment, but there are also legal issues that are gray. Since it is a medical procedure, even if it is under the supervision of a doctor, it cannot be said that there is definitely no problem under the Medical Practitioners Act for a nurse to perform body odor treatment. Ethically, it is absolutely not OK for a nurse to perform body odor treatment. I have been advising manufacturers about this issue for many years, but they have completely ignored me, and the thing I feared happened. Although it was not a treatment for underarm odor, a nurse was performing high-frequency treatment for wrinkles and sagging skin (reported as laser treatment) without the supervision of a doctor, which caused severe burns to the neck and resulted in a six-month recovery, causing a cosmetic medical incident in which a certain clinic was raided for professional negligence resulting in injury.The report included real names and even the name of the cosmetic medical device used. https://news.yahoo.co.jp/articles/98c0df8670df62a988c3d9b40ea6cdbff7afabcc It is unusual for police to investigate a medical institution for reasons other than fatal accidents. This case is just the tip of the iceberg, and the reality is that many problems occur as a result of nurse treatments. Our hospital has also received many consultations after problems with nurse treatments. It is unfortunate, but the cosmetic medical industry is building a business system that lowers the unit price for nurse treatments, promotes them, and attracts customers. In order to avoid lowering the quality of cosmetic medical care, perhaps it is time to reconsider the gray area cosmetic medical procedures performed by nurses.  
2021/11/20

Body odor treatment Suction surgery

Aside

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Body odor treatment suction method

What is the suction method?

Suction method is a suction method surgery, which is a surgical method developed by a procedure to remove and remove sweat glands that cause body odor by suction operation with a suction tube.

As a treatment for armpits, suction surgery was performed at cosmetic surgery clinics more than XNUMX years ago.

Suction method From the day of surgery, it is possible to date, there is no pain, scars do not remain, it is easy, etc. As a treatment method for armpits that can be easily received without downtime, a catch phrase by a certain cosmetic surgery clinic has been used in the past with a large advertising strategy. It is a treatment for armpits that has been carried out for a certain period of time.

At that time, surgery was performed by using a thin suction tube for liposuction, incising the skin of the armpit for several millimeters, and rubbing the subcutaneous tissue from the back side of the skin without peeling the skin as in the conventional armpit surgery method. Was carried out.

It was postoperative care that gauze fixation was not necessary because the armpit skin was not peeled off, but in reality, there were not a few complications such as postoperative bleeding and speciation.It is less effective than various conventional surgical methods because it is an operation that only scrapes out the subcutaneous tissue containing the sweat glands that cause the odor with a suction tube, and even if the odor and sweat are slightly reduced for several months, it is almost the same. It was an incomplete surgical procedure that returned to.For this reason, many complaints were made by patients who underwent suction surgery, and its effectiveness was denied. Currently, few medical institutions carry out suction surgery as a treatment for body odor.

Comparison of suction surgery and MiraDry

Unlike MiraDry, which is a non-invasive treatment method, suction surgery is inferior in effectiveness despite being performed by a doctor, and it cannot be said that it is actually an easy treatment method for body odor.

Unlike MiraDry, damage to the epidermis was characterized by almost no pain as long as it did not cause speciation.

Aspiration method for treating children's body odor

Treatment of body odor in children is more difficult than in adults.Aspiration is not the treatment of choice for children.Children have a high ability to regenerate tissues, and if sweat glands are not removed and destroyed more firmly than adults, there is an extremely high possibility of recurrence, and suction methods cannot be used to completely cure them.

Is the suction method possible at any part?

There was a case where it was also performed on Susowakiga, but treatment on the areola and anus is not indicated because treatment is not possible with the I line.

Suction surgery flow

XNUMX: Design of treatment range

XNUMX: Disinfection

XNUMX: Local anesthesia with xylocaine

XNUMX: Small skin incision

XNUMX: Insertion of suction tube, removal of subcutaneous tissue including sweat glands from the back side of the skin

XNUMX: Suture of the incision

XNUMX: Compression fixation Some medical institutions perform simple treatments such as applying gauze to the affected area to prevent skin peeling.

downtime

Most patients do not need to fix and remove the affected area after surgery, and most patients visit only the suture wound.Or, depending on the case, it is not necessary to remove the thread by using a meltable thread.

Completed with just one outpatient surgery　There were many cosmetic surgery clinics that were attracting customers by complaining about.The pain was less because the skin was not exfoliated, but there were cases where bleeding at the exfoliated site and speciation occurred after surgery because the fixation was not performed firmly.Since the range of treatment is small compared to other surgical methods, there is almost no risk of leaving ugly widespread scars or scar contractures.

Suction method market price

Although it is a suction surgery that is rarely performed nowadays,At that time, the market price was about XNUMX to XNUMX yen for surgery.

Concept of suction method surgery at Sakae Clinic

In our hospital, the suction method is

XNUMX: No effect can be expected

XNUMX: There is a considerable risk of postoperative blood speciation

XNUMX: As another treatment method for body odor, a highly satisfying EL method that ensures a permanent effect with less downtime.　https://sakae-clinic.com/skin_care/axillary_odor/　Can be provided to patients

The suction method is not used for the reason.

Who recommends the suction method?

Nowadays, there are more choices of treatments, and if you want a permanent effect, it is meaningless, so no one recommends it.

Features of suction method

It is a naming and surgical method developed for the purpose of attracting customers in the PR of a major cosmetic surgery clinic group during the heyday of surgery, and it is a half-finished treatment method that is not effective and most of them recur.It has no clinical significance.

Precautions for suction method

It is not a treatment for body odor that you should receive.It can be said that the operation of sucking the subcutaneous tissue including the sweat glands does not completely cure the hircismus and hyperhidrosis, and it is not only meaningless but also has a great negative effect as it leaves the skin wound.The late Dr. Masumi Inaba also enthusiastically stated that the suction method is a fraudulent operation as a treatment for body odor and that it can be asserted that it is not a treatment method that should be performed from an academic and ethical point of view. I remember.

2021/11/19

Wakiga Inaba surgical method

Director's Blog

Reading Time: <1 minute

Inaba surgical method

A landlord representing Japan in the treatment of body odor,Using the Inaba-type armpit remover developed by the late Dr. Masumi Inaba, the skin was peeled off with a surgical scissors called a long sweat gland from an incision of less than XNUMX cm, and then the Inaba-type remover was inserted subcutaneously into the skin. A surgical method to remove the Ecklin sweat glands, apocrine sweat glands, and sebaceous glands by pressing the upper side of the skin with the blade of a sword with a roller from the back side and sliding the blade applied to the back side..
When I was training as a cosmetic surgeon more than XNUMX years ago, I visited Dr. Masumi Inaba's Inaba Cosmetic Surgery in Asagaya, Suginami-ku, Tokyo many times. rice field.And he is one of the few doctors who received direct guidance on Inaba surgery.
At that time, I remember as yesterday that I was guided to my laboratory about hair growth theory, the mechanism of body odor, etc., and Professor Masumi Inaba and the best radical treatment method for body odor and hyperhidrosis.As it is now, armpit surgery and other treatments are not widespread, and Inaba surgery was famous as the only treatment that could be completely cured.Inaba Cosmetic Surgery attracted patients suffering from hircismus and hyperhidrosis from all over the country, but nowadays, the length of downtime and risks are due to the long downtime and the scars remaining after surgery. Due to the problem of scars and the lack of guidance, the number of doctors performing the procedure has dropped sharply.
At certain medical institutionsRoller clamp methodA similar modification of the surgical method is being implemented under the name.

Disadvantages of Inaba surgery

It is a method of exfoliating the armpit skin extensively and inserting an Inaba type remover to remove the sweat glands from the back side of the skin as much as possible, but it requires a long-term strong fixation of about XNUMX weeks called double tie-over, so originally If so, there are restrictions on daily life and physical restrictions due to downtime that requires long-term hospitalization.
No matter how small the skin incision is, the area of ​​peeling is wide and bleeding is likely to occur, and there is a risk of extensive skin necrosis when speciation occurs.
It is difficult to fix it firmly, and if you do not fix it firmly to the surgical site of the armpit with gauze etc., the shape of the peeled skin will be deformed into an accordion-like folded bellows shape, or a cyst will be formed after the operation, or it will become scarred. increase.
There were not many doctors who could perform Inaba-style surgery well because of the high skill of craftsmanship.
Currently, compared to Ladry, which is the mainstream treatment method that does not use a scalpel for the treatment of hircismus and hyperhidrosis, the current situation is that it is not widespread even if the effect can be expected to be completely cured due to advanced technology and downtime. ..

Inaba surgical procedure flow

XNUMX: Marking of the peeled area on the skin

XNUMX: Local anesthesia

XNUMX: Incision to the insertion site of the Inaba-type deleter

XNUMX: Skin exfoliation in the therapeutic range

XNUMX: Inaba-type remover inserted, sweat gland tissue removed from the back of the skin

XNUMX: Hemostasis

XNUMX: Make a small drain incision on the skin

XNUMX: Double tie-over fixing of peeled part

Inaba surgical method downtime

The incision is as small as XNUMX cm or less, but the peeling range of the skin is wide and strong fixation is required, and it is necessary to keep rest until the peeled skin engrafts with the mother bed.A minimum of XNUMX-XNUMX weeks of rest and fixation is required.
The arm must be raised and maintained at a right angle while it is fixed.
Downtime is a long remedy.
Fixed removal is XNUMX to XNUMX weeks later.It takes at least half a year for the scar to be inconspicuous as a skin color because the skin from which the tissue is scraped from the back side turns brown and pigmentation often occurs.

Treatment costs for Inaba surgery

The specific market price is currently unknown because there are few facilities that actually perform the Inaba ceremony.
In the case of a similar method, it will be around XNUMX yen.

Indication of Inaba surgical method

Those who do not mind scars, can tolerate long-term rest and downtime, and want to aim for radical cure with one treatment.

Significance of Inaba surgical method

The purpose is to complete one operation aiming for complete cure by implementing extensive treatment.
The downtime is long, and there are many complications such as skin necrosis due to blood type formation, postoperative skin scar contracture, epidermoid cyst, and folliculitis.
The incision is small and unobtrusive, but the exfoliated skin often causes pigmentation and scarring, which makes the skin at the surgical site discolored or bumpy.

Risks of Inaba Surgery

·downtime
・ The possibility of pigmentation and shape changes of exfoliated skin
・ May be accompanied by postoperative pain due to firm fixation
・ If not rested, blood speciation will occur and widespread skin necrosis will occur.
・ There is a possibility that a state of cyst formation and accumulation of liquid secretions called seroma will appear after surgery.
・ The peeled skin may shrink and form an ugly shape called scar contracture.

The future of Inaba surgery

* Before treatment with the EL method, I had been performing reduction surgery for Inaba surgery for many years.
The skin is peeled off only in a narrow area in the center, no complications occur after surgery, fixation is released in XNUMX days, and a method with less downtime and less pain for postoperative patients is devised. I have had an operation.
You will prioritize either taking effect or making scars less noticeable.Ideally, surgery should be effective and scars should be inconspicuous, but this is contradictory to surgery for hircismus and hyperhidrosis.
 In search of a new treatment method, we have developed the EL method, which is a treatment method that does not leave scars, can be expected to be completely cured, has no downtime, has no complications, and does not cause postoperative pain.
Currently, Inaba surgery is completely canceled and EL method is used as the main treatment for hircismus and hyperhidrosis. With more than XNUMX years of experience as a cosmetologist, EL is the best treatment for patients, including shearing, Inaba surgery, and many surgeries. ..
In recent years, a beauty surgeon who has never performed a case of armpit / hyperhidrosis surgery purchases only treatment equipment and entrusts all the treatment to a nurse, and treats armpit / hyperhidrosis extensively using advertising media. There are many medical institutions that carry out PR. Unless a specialist who has experienced all types of surgery and treatment is in charge of direct treatment, the results will not be satisfactory for the patient.We recommend a medical institution where a specialist with abundant treatment experience directly implements body odor and hyperhidrosis.There are few patients who are satisfied with the treatment of hircismus and hyperhidrosis by the nurse's treatment, and troubles occur frequently.We believe that the treatment of hircismus and hyperhidrosis, which is a medical practice, should be performed by a skilled specialist, not a nurse.
2021/11/18

What is Wakiga Surgery Insurance Coverage?

Aside

Reading Time: <1 minute

Wakiga Surgery What is Hair Resection?

There is an insurance-listed surgical procedure called hair resection, which removes the hairy skin of the armpit.Reducing the number of apocrine sweat glands in the armpit can be expected to suppress the armpit odor, but since the skin is lost by excision, not only ugly scars remain but also the contracture of the suture wound becomes stronger and the elevation of the upper limbs is restricted. There are big risks and disadvantages that can occur. Surgical costs are covered by insurance, so you can keep your own costs low...This hairy skin resection was a treatment for axillary odor that was performed in the early Showa period.It is a simple idea that is carried out in a surgical hospital and the skin where the odor comes out is cut and removed.Although the odor is reduced, the skin with normal function is excised, so naturally the defective part shrinks and a biological reaction occurs to heal the scar, causing a phenomenon called contracture.This is a method that not only causes so-called twitching and increases downtime, but also limits daily life and even risks dysfunction.I have experienced several cases since I became a cosmetologist.In each case, the patient was an elderly person who had been treated for axillary odor a long time ago, but he asked me to heal the torn area. Indications for axillary odor surgery with insurance The eligibility of surgery for axillary hyperhidrosis under insurance is determined as follows: "If the odor is so severe that it clearly interferes with the work of others and there is an objective need for additional medical treatment, it may be paid for. Mild cases are not covered." Therefore, it doesn't matter if the patient is "bothered" by it, but unless it is causing severe trouble to others, the surgery is not eligible for insurance. 6870. Skin flap method 3000 points 1660. Hairy skin excision XNUMX points XNUMX. Other XNUMX points XNUMX point is XNUMX yen If the initial consultation fee, drug costs, surgical material costs, etc. are added to the above and the patient is responsible for XNUMX% of the cost, that XNUMX% will be the cost of the surgery. The operation time is about 60 minutes, but there is no need to be hospitalized and one-day surgery is possible.is.Since it is a simple excision, no special surgical technique or technique is required.

downtime

Hairy skin resection is a treatment in the Showa period and is not a treatment that should be done in Reiwa.It is an extremely outdated treatment that simply removes the odorous skin tissue, ignoring postoperative scars and dysfunction.Skin resection can leave large scars and can limit the range of motion of the skin, such as scar contracture.It is a procedure and treatment that should never be performed in the present age of advanced medicine.I wonder why such anachronistic treatments are listed in the insurance medical treatment.It can be said that it is a treatment that no one is doing now.

Is there an adaptation?

Even if it is listed in the insurance, there should be few medical institutions in Japan that actually do it.Never take it.We recommend the EL method, which is the treatment method for Reiwa of armpits.https://sakae-clinic.com/skin_care/axillary_odor/ It is an excellent treatment for hircismus and hyperhidrosis that can be expected to have a permanent effect with little downtime.  
2021/11/18

What is the armpit surgery shearing method?

Aside

Reading Time: <1 minute

The standard armpit surgery, the shearing method

The most standard and most widely performed armpit odour surgery in Japan is the excision method. Armpit odour is caused by the decomposition of secretions from the apocrine sweat glands by resident bacteria on the skin. In one or two places in the centre of the hairy part of the armpit, where the density of the apocrine sweat glands that cause armpit odour is high, an incision is made a few centimetres in length, the skin is peeled and turned over, the apocrine sweat glands are exposed and actually visually inspected and removed with surgical scissors. After removing the apocrine sweat glands, the excision method involves firmly fixing the skin flap with gauze so that it can be attached to the base of the skin.

Effect

The part where the apocrine sweat glands can be removed by surely shearing like the skin of the armpit can be expected to be effective, but this surgical method requires a peeling technique of peeling the subcutaneous tissue from the skin.It is difficult to remove the skin over a wide area for armpits such as the hem and areola.For this reason, the areas where treatment can be performed are limited. Regarding the armpits, only the area around the center can be peeled off, and the skin around the armpits, that is, the upper arm and torso, cannot be peeled off completely. If a procedure is performed to peel off a wide area of ​​skin, hospitalization is required as a general rule, and a special method called double tie-over is used to fix the peeled skin with gauze in place, and long periods of rest are required in order to allow the peeled skin to attach to the base. downtime The postoperative downtime is long because the skin is incised and peeled off. This is because it takes time for blood flow to resume in order for the peeled skin to completely attach to the host bed. Strong pressure fixation is required to prevent the peeled skin from floating and forming a hematoma. If strong pressure fixation is not performed, bleeding may occur in the space, causing blood flow to be insufficient in the skin above the hematoma, leading to skin necrosis. Pressure fixation is required for at least one to two weeks. When fixing, the skin and gauze are firmly sewn together with thread, leaving unsightly thread marks. Not all cases of wounds after surgery are good. There are many cases where a capsule of a mass called a sebaceous cyst develops some time after the wound has completely healed and requires surgery to remove it. Therefore, this treatment was performed in an era when there was no appropriate treatment other than surgery, and it is rarely performed nowadays. It can be said to be a Showa-era armpit odor treatment. The surgical scars of the excision method are noticeable for several months, but after about six months the scars become less noticeable to a certain extent, and after several years they become less noticeable. This is not a treatment option for those who absolutely do not want to be left with scars. Patients for whom the shearing method is indicated

Surgery is also an option if you want to expect a certain degree of certainty and permanent therapeutic effect with one treatment.Considering the risk of downtime, scars and various postoperative complications, it is not recommended due to its few advantages over current medical levels and other treatments.

However,Since the pruning method is covered by insurance, you can have surgery at an insurance medical institution with insurance.

The cost of treating body odor is relatively low and the financial burden is reduced.

However, in the case of outpatient surgeryExtensive shearing is difficult and risky, so it is inevitably ineffective. If you wish to receive a wide range of pruning methods that are highly effective, you will need to be hospitalized at a medical institution with a specialist who has an inpatient facility, undergo surgery, and perform resting and fixation for about XNUMX to XNUMX weeks.

Surgery in the hospital is physically and financially burdensome, and considering the cost of hospitalization, it is not always cheap because it is an insurance treatment compared to cosmetology treatment.

Why is the shearing method covered by insurance?

Axillary odor is a disease that should be treated and is covered by insurance.

In the early Showa period, there is a history of rough surgery such as cutting and removing armpit skin, which is called the excision method, at a surgical hospital.Later, a relatively minimally invasive shearing method was developed and covered by insurance.

What is the failure of the shearing method?

If you have surgery with an inexperienced doctor, not only will it not be effective, but the chances of complications will increase.

The cause of the failure isWhen the doctor's achievements / experience and skill level are low.

 

What is the recurrence with the shearing method?

The biggest cause of recurrence is the halfway removal of the sweat gland tissue that causes the odor.It is exhausted.

When skin grafting is done as thinly as possible, the same technique is required to scrape it.andExcessive use can lead to skin necrosis due to poor circulation and postoperative skin contracture, leaving ugly scars such as contracture scars and hypertrophic scars.

It is difficult to adjust, and surgery is always experienced and can handle postoperative care. You need to see a specialist.

Importance of choosing a clinic

It is necessary to have surgery by the attending physician who clearly knows the number of cases of axillary odor surgery and years of work experience.

You need to choose a surgeon, not a clinic. There are no specialists with experience in armpit surgery at major cosmetic surgery clinics or well-known clinics.

I'm a cosmetic surgeon, so I'm a plastic surgeon, so I'm not good at pruning...There are also plastic surgeons and cosmetologists who have never seen or experienced treatment for axillary odor.

Especially at major cosmetic surgery clinics, there are actually cases where the director who has never experienced armpit surgery is in charge of armpit surgery.

You should thoroughly check your doctor's medical expertise, experience, and treatment record before undergoing surgery.

The price of the shearing method?

Insurance medical treatment depends on the out-of-pocket rate of insurance.

The total amount depends on the number of hospital visits, the presence or absence of treatment, the presence or absence of drugs, and the presence or absence of complications.

Outpatient surgery costs for insurance medical treatment,

One armpit about XNUMX to XNUMX yen　

Both armpits are about XNUMX to XNUMX yen.

At the cosmetic surgery clinic, you will have to pay for it, so it will range from XNUMX to XNUMX yen.

Scraping method FAQ

What is the postoperative pain?

The skin is exfoliated, but if it is firmly engrafted and bleeds and there is no speciation, there is no strong pain.

Anesthesia method?

We use a local anesthetic called xylocaine. It is a vasoconstrictor that contains epinephrine to prolong the anesthetic effect. Xylocaine with epinephrine is injected locally to achieve anesthesia. As a rule, surgery using general anesthesia is not performed due to the risks involved.

downtime?

Since it is necessary to fix the wound with gauze and tape after the operation, it is necessary to rest for XNUMX days after the operation so that the armpit cannot be lifted at all. Everyday life is possible.If you are hospitalized, you will have XNUMX-XNUMX weeks of downtime.

Complications / risks after surgery?

The most common complication is speciation due to bleeding from the exfoliated site after surgery.If not treated immediately, skin necrosis on the bloodline will definitely occur.There is almost no infection in the surgical site, but some time after surgery, cysts such as epidermoid cysts, folliculitis, and seromas may develop at the surgical site.

Is the effect certain?

Unfortunately, despite the heavy physical burden, the odor does not disappear completely.The reason is that the apocrine sweat glands cannot be removed at all in areas where the skin cannot be exfoliated.

Age for surgery?

The age at which the odor becomes a concern varies from person to person, but it can be as early as 10 years old or as early as the 4th or 5th grade of elementary school. Girls tend to become concerned about the odor earlier than boys. As a general rule, surgery is performed after high school age, when bed rest can be ensured.  

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