Hyperhidrosis Operations
The underarm surgical procedure involves curettage, excision, and liposuction. During excision, perspiration glands may be eliminated. They may be cleaned out in this manner during curettage. During liposuction, they may be suctioned out. As well as laser treatments and liposuction, combinations of central excision and curettage, liposuction and curettage, or liposuction and curettage may be useful. Occasionally, dermatologists achieve astounding results with such techniques. Each of these procedures may be performed under local anesthesia (meaning the patient is not entirely unconscious) and in an office (rather than a hospital). All of the mentioned techniques aim to injure or eliminate the sweat glands so that they can no longer produce perspiration.
Sweat glands are present just beneath the epidermis (where the skin and subcutaneous fat meet), making them accessible for such interventions. As the perspiration gland is also quite localized in the armpits, surgery is a viable option. Local surgeries are not performed for plantar hyperhidrosis (excessive foot sweating), palmar hyperhidrosis (excessive hand sweating), or facial perspiration for a variety of reasons, including the dispersal of scar tissue and sweat glands. Other treatments, such as Botox and iontophoresis, are preferable for these body regions other than the underarms. During liposuction, a general practitioner will use a small tube to suction out the outer layer of fat from the underarm perspiration glands.
Consequently, during curettage, a vital surgical instrument with a circular loop at the end is utilized along the skin’s underlayer to scrape out as many perspiration glands as possible or to nearly damage them to the point where they no longer function. While performing the curettage scraping procedure and suction-curettage with the liposuction catheter. Notably, excision, which entails the complete removal of armpit tissue consisting of sweat glands, is no longer recommended because excessive scarring can cause severe range of motion issues, to the point where a patient may not be able to move his or her shoulder normally.
The most recent liposuction technique shows promise for treating axillary hyperhidrosis. This technique combines liposuction with the use of a laser to liquefy your perspiration gland-containing tissue. The laser’s energy is directly applied to cells (consisting of sweat gland cells), destroying them so that the body can eradicate them or that liposuction can remove the damaged cells. One of the benefits of local surgery for excessive perspiration is that, depending on which glands are removed or injured, the results are sometimes permanent. The affected glands will no longer produce perspiration.
Even with surgical apparatus, sweat glands are too small to be visible, so even the most experienced skin specialist is operating in the dark. It is difficult for doctors to determine how many perspiration glands they are damaging or removing, especially as the results become increasingly variable. Axillary surgery may be performed under local anesthesia in a physician’s office. Patients may experience soreness for up to a week and must limit arm-intensive activities (such as lifting above the head, athletics, etc.) during this time.
If perspiration reduction has not been sufficient to control sweating from the left sweat glands, it is also necessary to repeat a method or use antiperspirants or Botox. Local surgery has not been linked to compensatory perspiration. As with any surgical procedure, there are significant complications such as infection. Depending on the number and size of incisions the doctor makes, there may also be swelling, bruising, scarring, and loss of sensation in the underarms. Local surgeries as a treatment for hyperhidrosis are often overlooked by health insurance companies, who therefore do not cover them. Botox, on the other hand, is FDA-approved for the treatment of axillary hyperhidrosis, so it is more likely to be covered by insurance.
Occasionally, a patient who requires axillary surgery and is a suitable candidate must pay for it themselves. It may also be difficult to find a dermatologist with experience in surgeries related to underarm perspiration. These are the most recent methods. If you believe that this may be beneficial for you, you should conduct research to find a qualified dermatologist to perform the surgery. Following is a concise summary of accepted local surgical treatments for axillary hyperhidrosis (excessive sweating):
Liposuction: Rates of sweat reduction range between 44% and 49%.
Curettage: A limited Taiwanese study of 19 patients (approximately 90%) revealed a remarkable to excellent response.
Liposuction and curettage: approximately 63% perspiration reduction rate
Extreme perspiration (hyperhidrosis) can be treated by a variety of methods, including armpit surgery. Experts typically recommend that patients begin with antiperspirants (prescription and/or over-the-counter formulations) and then, if necessary, progress to more effective treatments. We can treat moderate cases of hyperhidrosis without surgical intervention. The most common methods involve the use of sedatives, astringents, carbohydrates or sugar, beta-blockers, or antihistamine drugs. Injections of botulinum toxin, liposuction, and iontophoresis are additional extreme treatments we can attempt. If these do not work, surgical treatment may be necessary. The most effective treatment for hyperhidrosis is surgical endoscopic thoracic sympathectomy (ETS).
We use specialized instruments to precisely sever the sympathetic nerves. The operation takes approximately 40 minutes and requires two tiny (approximately 1.5 centimeters) incisions, one on each side of the chest. We use a camera so that we can observe the nerve. This method only affects the nerves in your palms and armpits. We do not employ this technique to treat nerves in the ankles or face. Practically as soon as you awaken from anesthesia, you must observe a significant improvement. These effects are almost universally permanent. Despite the fact that ETS is typically an invasive surgical procedure, you may experience a few pains promptly after the procedure. Many individuals only experience pain in the nerves and incision locations close to the incisions. (9)