-  it is associated with frequent complications, including pneumothorax and compensatory hyperhidrosis in other parts of the body (Saadia et al, 2001; Glogau, 2004). Excisional surgery can be complicated by infection, bleeding, and significant scarring (Cohen and Solish, 2003). Subcutaneous curettage and liposuction offers permanent efficacy and is associated with fewer side effects and less scarring compared with excisional procedures (Cohen and Solish, 2003; Lowe et al, 2004).
- Palmar hyperhidrosis is also treated topically or systemically, although sympathectomy surgery involving upper thoracic ganglionectomy or lumbar sympathectomy is usually not recommended for palmar hyperhidrosis. Endoscopic transthoracic sympathectomy for excessive palmar sweating has a high success rate and was initially the preferred surgical treatment option. However, this procedure requires general anesthesia and may not be successful (Cohen and Solish, 2003; Lowe et al, 2004). Like other surgical approaches, endoscopic transthoracic sympathectomy is associated with increased compensatory sweating in other body areas, which can occur in up to 26% of patients (Cohen and Solish, 2003; Lowe et al, 2004)
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 Even ETS for palmar hyperhidrosis doesn't get the usual enthusiastic thumbs up here....Notice they classified hyperhidrosis under "Autonomic Disorders"

Link to Autonomic Disorders ~ Neurtoxin Institute

Axillary hyperhidrosis can be treated surgically by excision of the sweat glands, subcutaneous curettage and liposuction, or surgical sympathectomy, usually performed endoscopically. Until recently, surgical endoscopic transthoracic sympathectomy was considered to be the most effective treatment for this disorder, but it is associated with frequent complications, including pneumothorax and compensatory hyperhidrosis in other parts of the body (Saadia et al, 2001; Glogau, 2004). Excisional surgery can be complicated by infection, bleeding, and significant scarring (Cohen and Solish, 2003). Subcutaneous curettage and liposuction offers permanent efficacy and is associated with fewer side effects and less scarring compared with excisional procedures (Cohen and Solish, 2003; Lowe et al, 2004).

Palmar hyperhidrosis is also treated topically or systemically, although sympathectomy surgery involving upper thoracic ganglionectomy or lumbar sympathectomy is usually not recommended for palmar hyperhidrosis. Endoscopic transthoracic sympathectomy for excessive palmar sweating has a high success rate and was initially the preferred surgical treatment option. However, this procedure requires general anesthesia and may not be successful (Cohen and Solish, 2003; Lowe et al, 2004). Like other surgical approaches, endoscopic transthoracic sympathectomy is associated with increased compensatory sweating in other body areas, which can occur in up to 26% of patients (Cohen and Solish, 2003; Lowe et al, 2004). Iontophoresis is an effective treatment for palmar or plantar hyperhidrosis, but the necessary electrical introduction of ions through the skin may produce an uncomfortable stinging sensation and must be repeated frequently (Atkins and Butler, 2002). 

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