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FREQUENTLY ASKED QUESTIONS:

What is the success rate of surgery?

The success for palmar or hand sweating is over 98% excellent. Facial sweating and blushing is eliminated 95% of the time. The success rate for axillary (armpit) sweating is approximately 70-90%. Plantar (feet) sweating is successful 75% of the time.

How long is the recovery?

The majority of patients go home the same day of surgery. There are out of bed and walking several hours after surgery. Work or school can be resumed within two days and full exercise in one week.

What are the side effects of surgery?

Risks of thorascopic surgery include infection, blood less, neuralgia (chronic pain), and injury to structures in the chest including the lung and nervous tissue. These complications are extremely rare. Heart rate changes can happen in a small number of cases. Gustatory sweating, a condition is which sweating increases while eating or smelling certain foods develops in uncommon cases. The major complications of the procedure are a Horner’s syndrome and compensatory sweating. These two side effects deserve particular mention.

A Horner’s syndrome is due to injury to the sympathetic nerves that innervate the eyelid and pupil. These nerves are located in the T-1 sympathetic ganglion, located just above the T-2 ganglion. Patients with a Horner’s syndrome will notice a lazy eyelid and a small pupil. The risk of a Horner’s syndrome with ETS surgery is less than 1%. If it does occur, it usually improves with time and does not affect vision. In the rare event that the condition is permanent, it can be successfully treated with plastic surgery. Dr. McCormack has pioneered the use of intraoperative nerve stimulation and monitoring to minimize the frequency of this complication. Check out Advances in ETS Surgery to learn more!

After ETS surgery, patients may experience compensatory sweating of the chest, abdomen, thighs and legs. This occurs in 30-50% of patients. Less than 2% of patients are bothered by this side effect. Compensatory sweating often improves with time. In general, problems with compensatory sweating increase with the number of sympathetic ganglion cut during ETS surgery. For example, a patient who has the T-2, T-3 and T-4 ganglion divided is much more likely to develop compensatory sweating than a patient who is treated only at T-2. Dr. McCormack uses intraoperative nerve stimulation and monitoring to precisely lesion only the ganglion that cause the hyperhydrosis. This technique minimizes the number of sympathetic ganglion divided and reduces the incidence of compensatory sweating. Check out Advances in ETS Surgery to learn more!


If I have axillary (armpit) sweating, should I have the surgery?

If palmar sweating is also present, the success rate is very good. However, if the sweating is just in the armpits and not in the hands, ETS may not be successful. With isolated axillary sweating, Dr. McCormack has found that several levels of the thoracic sympathetic chain must be divided at surgery. This results in an increased incidence of compensatory sweating and may be a source of patient dissatisfaction.

Who cannot have this surgery?

Those patients with previous chest surgery or significant pulmonary disease may not be candidates.

Can I get help with financial issues? What if I don't have insurance?

We work with CASSPP (California Specialty Services for Private Patients) to assist patients with questions about financing their surgery or insurance. To find out more information about CASSPP and the services they offer, visit their web site CASSPP.com.

Who cannot have this surgery?

Those patients with previous chest surgery or significant pulmonary disease may not be candidates.

Can I speak with other patients who have had the ETS procedure?

Please contact our office. We have a list of patients who would be happy to talk to you!

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