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Page 4 of 10 Tanaka et al. Plast Aesthet Res 2020;7:17 I http://dx.doi.org/10.20517/2347-9264.2020.12

A B

C D

E F

Figure 1. Closed-curettage surgery using the suction-assisted cartilage shaver system. A: the shaver is composed of an outer cannula
with grid (left) and serrated inner cannula (right); B: the operating area is hair-bearing skin with a 5-mm margin; C: following subdermal
undermining, the shaver is inserted from the edge of the marked region; D: the axillary skin is so thin that the shaver can be seen
through the skin; E: the wound is closed with nylon sutures after insertion of a drainage tube, and two quilting sutures were made in this
case; F: ten-month postoperative photograph. Note that axillary hair appears to have been almost permanently removed

The efficacy of each procedure was assessed by determining the rate of recurrence, which was mainly
based on the patient’s self-reported complaint or occasionally assessed by a physician performing the gauze
test. The recurrence rate included overall assessments such as “not improved” or “ineffective”, as well as
“recurrence”. The complication and recurrence rates of the patients who underwent SACS closed curettage
were compared with those rates of the patients who underwent open excision.

Patients followed-up postoperatively for ≥ 3 months were included in this survey. Some patients graded the
level of their subjective satisfaction for the entire treatment program (factors including surgical procedures,
postoperative pain, discomfort, outcome, scar appearance, and cost) with a visual analog scale ranging
from 0 (not satisfied) to 10 (fully satisfied).