You had bromhidrosis surgery, and after some time you notice the smell again — for many people, the first thought is: "Has it come back?"
That worry is understandable, but don't jump to a conclusion yet. "Odor after surgery" can actually stem from several completely different situations, and each one is handled very differently. Sorting out the cause is the first thing to do before deciding what comes next.
"The Smell Is Back" Doesn't Always Mean "Recurrence"
Let's say this up front: "smelling odor again after surgery" and "bromhidrosis recurrence" are not the same thing. Clinically, post-surgery odor falls roughly into three categories:
- Residual glands: some apocrine glands (the sweat glands responsible for body odor) were never fully cleared, so a portion remained — which means the odor never truly disappeared completely, or became noticeable again once you healed.
- True recurrence: glands that have been removed don't, in principle, regrow to anywhere near their original number — so genuine "recurrence" is actually relatively uncommon.
- Not recurrence at all: the odor comes from another source (a different body region, or a temporary factor) and gets mistaken for underarm bromhidrosis coming back.
Of these three, the first is by far the most common.
Key takeaway: When most people say "recurrence," the more common reality is "residual glands that were never fully cleared," not glands regrowing. Getting this distinction right keeps you from using the wrong approach — and from worrying for nothing.
Most Often, It's "Glands That Were Never Cleared"
The results of apocrine gland clearance surgery are directly tied to how thoroughly the glands were removed. If the clearance was incomplete the first time and a portion of glands was left behind, the odor isn't "reappearing" — it has been there the whole time, and you've simply started noticing it again.
This is also why, even though it's all called "bromhidrosis surgery," some people have almost no odor afterward while others feel "like nothing was done" — the difference often isn't whether surgery happened, but how thoroughly the glands were cleared. I cover "why the same surgery can produce such different results" more fully in a separate article, does bromhidrosis surgery actually work.
The difference between residual glands and true recurrence matters, because the approach for residual glands is to "go back and clear the areas that were missed," which is a different clinical line of thinking from "glands regrowing."
True "Recurrence" Is Actually Uncommon
Apocrine glands that have genuinely been removed don't regrow on their own to their original number. So in clinical follow-up, as long as the glands are fully cleared at the first surgery, our goal is complete apocrine gland clearance with no recurring trouble over long-term follow-up.
Of course, no surgery can use the word "guarantee," and everyone's constitution and recovery differ. But mechanistically, "glands regenerating in large numbers" is not the norm — which is exactly why, when someone has "odor again after surgery," I look first toward "residual glands" rather than assuming it "grew back."
It Might Not Be Recurrence at All
There's one more situation that's easily overlooked: the odor isn't actually coming from where the surgery was done.
- Body odor doesn't only originate in the underarms — the areola, perineum, scalp, and feet can all produce odor too, and sometimes it's another region speaking up.
- Odor that's one-sided, occasional, or only noticeable under certain conditions (stress, diet, heat and humidity) may be temporary rather than a problem in the surgical area.
- Changes in "your own sensitivity to odor" can be mistaken for the smell coming back.
To tell these apart, rather than frightening yourself, it's better to describe the actual situation clearly and let your doctor help locate the source. Clarifying "where the odor is coming from" is often more crucial than "whether it's recurrence."
How Can You Tell on Your Own First? Ask Yourself a Few Questions
Before making a trip to the clinic, these few questions can help you narrow things down:
| Ask yourself | Leans toward |
|---|---|
| Has the odor "always been there, just varying in degree," or did it "completely disappear and only come back later"? | Always there → leans residual; disappeared then returned → needs clarifying |
| Is the noticeable odor on the same side, or both sides? | One-sided → check for local residual glands or another source |
| Is it present at any time, or only after heat / stress / certain foods? | Only in specific situations → possibly temporary, not a gland problem |
| Besides the underarms, is there odor in other areas too? | Yes → the source may not be the original surgical area |
This table isn't for self-diagnosing and drawing conclusions — it's to help you organize the information. Bringing these observations to a consultation will get you to an answer faster than just saying "I think I smell again."
If It's Confirmed to Be Residual, What's the Next Step?
If the assessment confirms it's "residual glands that were never fully cleared," then the direction is clear: re-treat the areas that were missed. This kind of "touch-up clearance / revision" is a more specialized topic, involving precise clearance again in an underarm that has already been operated on — its difficulty differs from a first-time procedure, and this part falls under surgical technique.
Already operated on elsewhere with disappointing results, and wondering whether it can be re-treated? We have a full explanation of residual apocrine gland re-clearance and how to judge multiple revisions on the Minimal-Cut Surgery dedicated page → Go to the Minimal-Cut Surgery page to learn about revision assessment
Whether to do it again, and when, has no one-size-fits-all answer — it depends on the extent of the residual glands, the condition from the previous surgery, and how much it's currently troubling you. If you're stuck in the uncertainty of "odor after surgery," rather than guessing over and over, bring the situation in for a consultation — you can start with the underarm bromhidrosis surgery page, or book a consultation directly for an assessment by Dr. Ta-Ju Liu. Sort out first whether it's "residual, true recurrence, or not recurrence at all," and every step afterward will stay on the right track.