When medications fails to stop sweaty hands, surgery is often the last option. In the last 2 decades, surgery to treat sweaty hands has been refined. Unlike the old days, surgery today is done with small incisions on the chest and the downtime is minimal. It is important to remember that surgery for sweaty hands is never an emergency and you should always clarify the surgeon’s credentials and experience before going under the knife.

How is surgery for sweaty hands done?

Surgery for sweaty hands is usually done as an outpatient or in some cases, an overnight stay in the hospital is required. The surgery does require general anesthesia. Once you are asleep, the surgeon will make a very tiny incision on the side of your chest and insert a thin camera. The nerve which is known to stimulate secretion is identified and though another small incision near the armpit, another instrument will be inserted and the nerve will be cut and clipped. The procedure may take 60-90 minutes. In many cases, the surgeon will insert a thin tube in the chest overnight to help expand the lung and prevent accumulation of fluid and air. The tube is removed in the morning. Some surgeons perform the same surgery on the other side of the chest at the same time and other surgeons wait to determine the results before they proceed with surgery on the other side.

What is the recovery after surgery for sweaty hands?

Because the incision is small, the pain is less. However, you will still need to take prescription strength pain pills for a few days. You will also need to perform deep breathing exercises and start moving the arm on the surgery side to regain motion. Most people recover within 5-7 days.

When do I see the results?

The results of the surgery are immediate. When you wake up in the morning, you will see less or no sweating of the hand. The effect is real dramatic. The benefits of surgery are permanent. The majority of patients are pleased with the results.

What is one major problem with surgery?

When the surgeon clips the nerve on one side of the chest, in at least 30-50% of patients there is development of compensatory sweating on the other side. This does not occur immediately and does not occur in everyone. Hence, some surgeons will operate on one side initially. They will follow the patient and only operate on the other side, if compensatory sweating occurs. Sometimes the compensatory sweating is not even bothersome and there is no need for a second procedure. The problem is if compensatory sweating occurs and you need surgery, then you again have to undergo anesthesia and the costs are magnified.

Who does surgery for sweaty hands?

It is vital to seek a thoracic surgeon because these individuals know the anatomy of the chest. Never let any other surgeon do this surgery because the potential for life threatening complications is real. There are countless reports of patients being injured severely when the surgery is done by inexperienced surgeons.

What are complications of surgery for sweaty hands?

Some complications include:

Failure of the surgery to work- this occurs if the surgeon does not know what he or she is doing and cuts something other than a nerve.

Bleeding

Pain

Infection

Air in the chest cavity (pneumothorax)

Injury to the lungs

Drooping of the eyelid (this occurs because the surgeon also damages the nerve that control the eye muscles-this is a permanent injury).

What is cost of surgery for sweaty hands?

The surgery for sweaty hands is prohibitively expensive. It depends on which surgeon you go to and where you live (West coast is generally more expensive than the east coast). Expect to pay anywhere from $10,000-$30,000. Only a few insurance plans cover the cost of surgery but most do not. This surgery is considered cosmetic and even medicare or medicaid does not cover it. Always confirm what the total cost will be because many surgeons often forget to tell you the cost of anesthesia, the anesthesiologist fee and cost of an overnight stay.