World’s leading experts in sweaty hands and feet surgery.

Hyperhidrosis sufferers might sweat all over their body (generalized hyperhidrosis). More often, the sweating is localized in one or more areas (focal hyperhidrosis). Commonly, sufferers have:

• Sweaty palms (palmar hyperhidrosis) and
• Sweaty feet (plantar hyperhidrosis)

But focal hyperhidrosis can also occur in the armpits, the groin and the rear end.

Hyperhidrosis is a genetic condition — about 66% of patients have a family history.

The excessive sweating is a result of overactivity in the sympathetic chain, a collection of nerves that deliver information to the body about stress and impending danger.

These nerves are responsible for your fight-or-flight response, so it is no surprise they also control the sweat glands in your hands, feet and other areas.

The nerves responsible for hand sweating (palmar hyperhidrosis) are in the upper part of the chest (thoracic) cavity. The nerves responsible for foot sweating (plantar hyperhidrosis) are in your lower back (lumbar region).

Hyperhidrosis is not caused by:

• An overactive thyroid
• Anxiety
• Diabetes

However, there are reasons for heavy sweating that are not hyperhidrosis. It is important your surgeon is qualified to rule out other causes such as:

• Hyperthyroidism
• Psychiatric disorders
• Menopause
• Obesity
• Medications

Doctors have tried to treat excessive sweating with pills, lotions, neurotoxin injection, deodorants, electric devices, acupuncture and biofeedback. If you have experienced any of these prescribed or recommended for you, it will not surprise you to hear that these treatments have very low success rates for severe cases of excessive sweating.

The first surgical treatments for hyperhidrosis were performed more than 50 years ago. For decades, surgeons lacked the fine tools we have today for precise, technical surgeries. As a result, these early surgeries were invasive. Patients were cut wide open at the back, chest or neck.

In the 1990s, endoscopes made “keyhole” surgery possible for hyperhidrosis. An endoscope is a fiber optic camera with a tool attached. Endoscopes allow surgeons to thread their way through small incisions rather than making invasive cuts.

With endoscopes, hyperhidrosis surgery could be performed in an outpatient procedure. Patients started walking out of the facility within hours of their surgery.

Although many surgeons can perform keyhole surgeries, the techniques involved in hyperhidrosis surgery are highly specific. The techniques take years of practice under the supervision of a surgeon who has mastered them.

While the sympathetic chain (the overactive nerves causing excessive sweating) is similar in most people, the ways in which patients suffer can variety quite significantly. Only experienced surgeons will be able to identify these abnormalities and solve any issues that arise.

Unfortunately, there are few surgeons in the world who specialize in hyperhidrosis, and only two who can operate on both hands and feet. One of them is our co-founder, Dr. Basseri.

Our surgical procedure boasts a 99.2% success rate. Our effectiveness is a result of a diligent process that has been studied and refined for decades:

• We carefully screen patients so that we are operating only on individuals for whom surgery is most likely to work. This surgery is not suitable for everyone.
• We apply the right surgical technique at the right level of the sympathetic chain for optimal results.

You might have read about problems arising after hyperhidrosis surgery. It is important to understand the context of those experiences. Poor results are more common when surgeons:

• Apply the right technique at the right level to the wrong patient or
• Apply the wrong technique at the wrong level to the right patient

Because of our deep experience, The Center for Hyperhidrosis takes proactive steps to ensure the procedure will be successful.

At The Center for Hyperhidrosis, we have refined our approach over decades of world-class research and clinical trials for the best patient outcomes.

• We make minimal incisions, which means patients can return to normal activities in almost no time at all.
• Our endoscopic instruments are custom made for hyperhidrosis surgery.
• In operations for palmar hyperhidrosis (sweaty hands), we approach the nerves lower down than most surgeons do — at the T3 or T4 level rather than at the T2 level. This leads to much better results for the patients because it reduces compensatory sweating in other areas.
• We use titanium clips instead of burning or cutting the nerve. Clipping the nerve means the procedure is reversible. We can simply remove the clip in the unlikely event that this is necessary. A cut or burnt nerve cannot be restored.
• We have refined different surgical techniques depending on where the hyperhidrosis is presenting.
• We close the incision internally with absorbent sutures so it’s not necessary to come back to have them removed.
• The surgeries are performed at a fully accredited AAAHC outpatient surgical facility.
• The surgeons are supported by highly trained nurses and experienced staff who provide a safe, caring and professional environment for surgery.

The nature of hyperhidrosis means the results of successful surgery are immediate.

As soon as your nerve is clipped, the excessive activity in your sympathetic chain ceases immediately.

The first thing you will notice when you wake up from surgery is that you are dry and warm.

Our hyperhidrosis surgeries are performed on an outpatient basis. Patients typically undergo general anesthesia for about 1-2 hours, the length of the average surgical procedure.

Two hours after surgery, most patients are on their feet, walking out of the medical center, sweat free.

In about a week, patients are back to work and are able to perform physical activity.

Endoscopic thoracic sympathectomy (ETS) is the only proven surgical solution to excessive hand sweating (palmar hyperhidrosis).

The operation on the chest is quick (about an hour) and is performed under general anesthesia that requires only two small incisions (5mm and 10mm) through which the surgeon can insert the endoscope.

ETS is a reversible procedure because we clamp the nerves rather than burning or cutting them.

Endoscopic lumbar sympathectomy (ELS) is the surgery most often recommended for patients who suffer from severe excessive foot sweating (plantar hyperhidrosis) as their primary or only area of excessive sweating.

We might also perform ELS in cases where patients did not see results from ETS.

The surgery on the lower back is performed under general anesthesia and lasts between one and two hours. It involves just three small cuts. The longest is only about 1.5 cm and the others are about half as long. The surgeon threads the endoscope through the incisions to perform the surgery.

Like any surgical procedure that attempts to correct physiological genetic problems with mechanical solutions, recurrence of the original problem is always a possibility. However, the odds of recurrence are low. And the possibility is least likely when your surgeon has extensive experience and knowledge, especially as anatomical variations are possible.