Minimally Invasive Surgery for Facial Blushing: Options in Taiwan

Surgery for treating facial blushing?

Hello, doctor.
I have been prone to blushing easily since childhood.
I tend to blush during embarrassing situations or when I feel awkward, which causes me significant psychological stress.
I often worry about whether I will blush uncontrollably while talking to others, making me feel anxious.
I saw online that there is a minimally invasive procedure for treating blushing, but it seems to be more common in Hong Kong.
Could you please tell me where in Taiwan such sympathetic nerve minimally invasive surgeries are performed? Also, are there any potential side effects after the surgery, such as abnormal sweating in certain areas or throughout the body? I have been concerned about this blushing issue for many years, and the pressure is quite overwhelming.
Thank you!

A Dong, 30~39 year old female. Ask Date: 2013/02/03

Dr. Lai Zhaokang reply Neurosurgery

1.
Endoscopic sympathetic nerve block is typically performed under general anesthesia.
Small incisions of approximately 1 cm are made on both sides of the axilla, through which an endoscope is inserted into the thoracic cavity to block specific sympathetic nerves located at the anterior edge of the thoracic spine (usually accomplished using electrocautery or clips).

2.
The procedure itself is simple and quick, and it is covered by health insurance (though prior approval is required).
However, postoperative complications such as compensatory sweating can be bothersome for patients, which is a primary reason why this procedure is currently not encouraged.
Therefore, it is advisable to discuss this with your neurosurgeon.
3.
This surgery was invented by the renowned Taiwanese neurosurgeon Professor Kao Ming-Jian.
Essentially, Taiwan is the birthplace of this procedure, and most neurosurgeons in Taiwan are capable of performing it, so there is no need to travel to Hong Kong.
4.
However, I want to emphasize again: postoperative complications such as compensatory sweating can be troublesome for patients, which is a primary reason why this procedure is currently not encouraged.
Therefore, it is advisable to discuss this with your neurosurgeon.
Best wishes to you.

Reply Date: 2013/02/03

More Info

Minimally invasive surgery for facial blushing, often referred to as sympathetic denervation or endoscopic thoracic sympathectomy (ETS), is a procedure that targets the sympathetic nervous system to reduce excessive sweating and facial blushing. This condition, known as erythrophobia, can lead to significant psychological distress, as you have described. In Taiwan, there are several medical facilities and specialists that offer this type of procedure, particularly in larger cities such as Taipei and Taichung.

1. Where to Find Treatment: In Taiwan, you can consult with plastic surgeons or dermatologists who specialize in minimally invasive procedures. Hospitals affiliated with universities or those that have a department of plastic surgery or dermatology are likely to offer ETS. It is advisable to look for clinics that have experience with this specific procedure, as it requires specialized skills.

2. Procedure Overview: The ETS procedure involves the surgical interruption of the sympathetic nerves that control facial blood flow. This is typically done through small incisions and the use of endoscopic techniques, which minimizes scarring and recovery time. The surgery is usually performed under general anesthesia, and patients can often go home the same day.

3. Potential Side Effects: While ETS can effectively reduce facial blushing, it is important to be aware of potential side effects. One of the most common concerns is compensatory sweating, where other areas of the body may experience increased sweating due to the disruption of the sympathetic nervous system. This can occur in areas such as the back, abdomen, or legs. Other potential side effects may include changes in skin sensation or, in rare cases, Horner's syndrome, which can affect pupil size and eyelid droop.

4. Consultation and Follow-Up: Before undergoing the procedure, it is crucial to have a thorough consultation with a qualified surgeon. During this consultation, you should discuss your medical history, the severity of your condition, and any concerns you may have about the procedure and its outcomes. The surgeon will likely perform a physical examination and may recommend additional tests to ensure you are a suitable candidate for the surgery.

5. Psychological Considerations: Given that your condition has caused significant psychological stress, it may also be beneficial to consider counseling or therapy as part of your treatment plan. Addressing the emotional aspects of facial blushing can be just as important as the physical treatment.

In conclusion, while minimally invasive surgery for facial blushing is available in Taiwan, it is essential to approach this option with careful consideration and thorough research. Consulting with experienced medical professionals will help you make an informed decision that aligns with your health needs and personal circumstances.

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