Breach procedure for axillary hyperhidrosis.

Dear Editor, We read with interest the communication on ‘A simple and practical method for axillary osmidrosis resection’ by Liu X, Mao T, Lei Z, Fan D appeared on JPRAS 2009.1 We found the description of the technique very useful with the support of intra-operative pictures. The use of artery clips to evert the skin flaps can be easily reproduced. However it is surprising that the Authors did not consider and mention in the References a paper by Mr N Breach appeared in the Annals of the Royal College of Surgeons of England in the late 70ies,2 when he was Senior Registrar at the Plastic Surgery Department of the Queen Victoria Hospital, East Grinstead, UK. Since then this latter procedure for surgical treatment of axillary hyperhidrosis has been widely adopted, [3], [4] and [5] especially in the Western world and in the UK where is known as the ‘Breach’ procedure. The main difference with the technique described in the paper by Liu X et al. consists in the number of incisions that has now been minimized.