Reversing Compensatory Sweating: Can Previous Surgery Tools Be Removed?

Surgery for palmar hyperhidrosis without nerve ablation?

Hello, Doctor.
I underwent a surgery for palmar hyperhidrosis 13 years ago.
At that time, the doctor informed me that if I could not accept the compensatory sweating that might occur post-surgery, this new type of surgery would not require nerve destruction and could be reversed by simply removing the tools used to compress the nerves.
Unfortunately, the compensatory sweating has become increasingly severe over time.
I would like to ask the doctor if, after nearly 13 years post-surgery, it is possible to remove the devices that were placed initially and restore the function of the sympathetic nerves? Thank you for your assistance!

Yuan, 30~39 year old female. Ask Date: 2011/07/25

Dr. Ding Xianwei reply Neurosurgery

I am not familiar with your surgery, so I cannot provide an answer.
I sincerely apologize.

Reply Date: 2011/07/25

More Info

Reversing compensatory sweating after a sympathectomy, such as the one you underwent 13 years ago, is a complex issue that requires careful consideration of various factors. The surgery you had likely involved interrupting the sympathetic nerves that control sweating in your hands, which can lead to compensatory sweating in other areas of the body, such as the trunk, legs, or face. This phenomenon occurs because the body tries to maintain homeostasis by redistributing sweat production to other areas when the original sweating mechanism is disrupted.

1. Can the surgical tools be removed?
In theory, if the surgical procedure involved the placement of devices or clips to compress or cut the sympathetic nerves, it may be possible to remove these tools. However, the success of such a procedure in reversing compensatory sweating is not guaranteed. The nerves may have undergone changes over the years, and the body may have adapted to the altered nerve pathways. Therefore, while the removal of surgical tools might restore some function, it may not completely reverse the compensatory sweating.

2. Timing and nerve regeneration:
After 13 years, the nerves may have formed new pathways or connections, which complicates the potential for recovery. Nerve regeneration is a slow process, and the longer the time since the initial surgery, the less likely it is that removing the tools will restore normal sweating patterns. The body’s compensatory mechanisms may have become more entrenched, making it difficult to revert to the pre-surgery state.

3. Risks and considerations:
Any surgical intervention carries risks, including infection, nerve damage, and the possibility of worsening symptoms. Before considering surgery to remove the tools, it is crucial to have a thorough discussion with a qualified surgeon who specializes in this area. They can provide insights into the potential outcomes, risks, and benefits based on your specific situation.

4. Alternative treatments:
If surgery is not a viable option or if you are hesitant about the risks, there are alternative treatments for managing compensatory sweating. These may include:
- Botox injections: Botulinum toxin can temporarily block the nerves that cause sweating in specific areas, providing relief from excessive sweating.

- Medications: Anticholinergic medications can help reduce sweating but may have side effects.

- Lifestyle modifications: Wearing breathable fabrics, using absorbent powders, and staying in cool environments can help manage symptoms.

5. Consultation with specialists:
It is advisable to consult with a specialist in neurosurgery or a dermatologist who has experience with compensatory sweating and sympathectomy. They can evaluate your condition, discuss the feasibility of removing the surgical tools, and explore other treatment options tailored to your needs.

In conclusion, while it may be possible to remove the surgical tools placed during your initial procedure, the success of reversing compensatory sweating is uncertain and depends on various factors, including nerve adaptation and the time elapsed since the surgery. A thorough evaluation by a specialist will help you make an informed decision about your options moving forward.

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