There are several surgical options available for the treatment of excessive sweating.
Superficial liposuction is used for underarm sweating. Using a small special cannula the sweat glands are removed. The procedure takes about an hour and is done in office operating room under local anesthesia with light sedation. The patient usually goes home within a couple of hours. The success rate is about 95%. Recovery takes about 1-3 weeks.
Axillary Sweat Gland Removal This surgery involves removing sweat glands from the armpits by surgically excising them. It tales a couple of hours and is done under general anesthesia or local with sedation. The scar is quite large. Usually a Z-plasty needs to be done to prevent scar contracture. Unfortunately, the scar can become hypertrophic and restrict shoulder motion.
Endoscopic Thoracic Sympathicotomy The main surgical treatment for excessive sweating is endoscopic thoracic sympathicotomy (or sympathectomy). It is performed in an operating room under general anesthesia. This is a surgical procedure where a lighted scope is inserted through the armpit on both sides into the chest cavity over the lung, and the sympathetic nerves to the face and upper arms are cut, crushed or destroyed.
This procedure, known as ETS, will not usually help people with hyperhidrosis of the underarms, feet, or body, but may be very helpful for hands or face. Some patients report that after surgical sympathectomy a regular deodorant is enough to control their armpit sweating whereas before the operation it did not help.
The patient usually go home the same day, and can expect a full recovery in about 1 week. The improvement of sweating is immediate. However, here are complications of this surgery that include pneumothorax is a life threatening condition when excessive air is collected in the chest cavity outside of the lungs. Chest tube may need to be placed to save life.)
Horner's syndrome (about 1% of cases), bleeding, infection and injury to the surrounding tissues.
There is another problem with this surgery. Many patients may develop compensatory sweating elsewhere, which may be troublesome. Also this surgical procedure is permanent, so that if one is suffering from compensatory sweating after the surgery, there is no other treatment other than medication or antiperspirants to control it. Many insurance companies will not cover this procedure which can cost between $5,000 and $10,000.
If you are considering ETS, you should obtain multiple medical opinions on all the options available to you prior to the surgery. Make sure you consult with the doctor who provides Botox treatments and who DOES NOT perform this procedure.