Take the first step towards freedom from hyperhidrosis
Opening hours: Mon to Thurs 9am-5pm
Friday 8.30am-4.30pm
Opening hours: Mon to Thurs 9am-5pm
Friday 8.30am-4.30pm

FAQS

Leading vascular surgeon for excessive sweating in Melbourne

Here at North Western Vascular Surgery in Melbourne, we understand that you may have questions about our treatment options for excessive sweating or facial blushing. Our friendly and experienced team are always
happy to provide the support you need, as well as answer questions regarding ETS, lumbar sympathectomy or MiraDry.

Please feel free to contact us by phone during office hours or by email. However it is always recommended that patients see Dr Bell to discuss symptoms and best mode of treatment.

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Frequently Asked Questions

  • What is the success rate following sympathectomy?

    The success rate varies according to the condition for which the sympathectomy is being performed.

    In those that have the procedure for sweaty hands, the success rate (i.e. achieve dry hands) is very close to 100%. It is important to emphasize that the benefit is permanent. Some patients (less than 5%) might experience a bout of hand sweating in the first week, but this is not an indication of a poor response, and is never sustained.

    For patients undergoing a sympathectomy for facial blushing, over 90% will no longer blush after the sympathectomy. The response for blushing of the neck and upper chest is a little less predictable.

    For axillary hyperhidrosis, the success rate is about 70%. This is because the sympathetic nerve supply to the axillary sweat glands, can sometimes arise form ganglia (nerve cell bodies) well down and relatively inaccessible on the sympathetic chain. For that reason I have abandoned sympathectomy for patients with axillary sweating as miraDry is a much better option for this.

  • What are the main risks of the procedure?

    The main complication is rebound sweating or compensatory hyperhidrosis. In response to ablation of the sympathetic chain, the brain sends signals to the sympathetic nerves below to work a little harder. Indeed 30 – 40% of patients experience at least some degree of rebound sweating. Fortunately in most it is very mild and of no concern. However, for one in 50 patients, the rebound can be quite severe, causing spontaneous sweating on the torso, back or front. I have had patients who regret that they had the procedure because of this complication, and everyone is warned of this.

    Horner’s syndrome which results in a droopy eyelid and constricted pupil, will occur if the Stellate ganglion is ablated. This occurs rarely, one in 1000 cases, usually due to misinterpretation of the anatomy by the surgeon. I believe this is far more likely to occur if the operator is inexperienced.

    Gustatory sweating, which is facial sweating following eating, particularly in response to spicy foods is a form of rebound occurring in 5% of patients.

    Chest complications such as pneumothorax or chest infections are very rare, but can occur. It is however quite common to experience heaviness in the chest and sharp pain often at the back, particularly with coughing and sneezing, referred to as pleuritic pain in the first week.

    Some patients (less than 5%) notice a marked difference in temperature between the upper torso and lower torso. In rare cases it can become somewhat disconcerting.

  • How long will I need to stay in hospital?

    Most patients stay overnight, and are discharged the following morning. If the procedure is performed early in the day, I am happy for patients to go home the same day, as long as a responsible adult is at home to care for the patient.

  • How much time off work will I require?

    I recommend a week off work, especially if the work is of a physical nature. Sharp chest and back pain is common in the first week, and often requires anti-inflammatory medications such as Nurofen to control the pain. Having said that, a number of patients return to work earlier and seem to manage quite all right.

  • How long after the procedure can I fly?

    Particularly for my interstate patients, this is often asked. All patients have a post-operative X-ray to exclude a pneumothorax (residual air in the chest cavity). This is rarely of any consequence and settles spontaneously but I caution patients against flying until the pneumothorax has resolved completely. Without a pneumothorax, I usually recommend 4 to 5 days before flying.

  • If I get rebound sweating, can it be treated?

    Bad rebound, which fortunately is very uncommon (about one in 50 cases) is the complication I fear most for my patients, as it is out of my control.

    In most cases the rebound sweating does decrease with time, but this cannot be guaranteed for all.

    From a practical viewpoint, there is no surgical option for rebound sweating. Certain medications with anti-cholinergic properties (eg Ditropan) can be helpful in this setting.

  • How is the sympathectomy performed?

    There are many ways of performing a sympathectomy, including cutting the nerve, clamping the nerve, excising the nerve or ablating the nerve. I choose to ablate (by electro-cautery) the ganglia, which are the nerve cell bodies form where the nerves are derived. This guarantees that the objective of the procedure (i.e. dry hands or eliminate blushing) is far more likely to be achieved.

    I am not a proponent of clamping the nerve, as this results in an incomplete sympathectomy and does not result in reversal of rebound sweating with removal of the clamps.

  • What is the cost of the procedure?

    This is not regarded as a cosmetic procedure, and is recognised by the Medicare Benefits Schedule.

    If you have private health insurance, most of your hospital costs will be covered. Medicare and your health fund will cover you to the schedule fee, though there will be an out-of-pocket component, which does vary from fund to fund, but is in the vicinity of $1500.

    With no private health cover, it will be an expensive undertaking, costing up to $8000 out of pocket. Please download more details of prices Here

  • In which hospitals is the procedure performed?

    I perform thoracic sympathectomies at 3 hospitals:

    John Fawkner Private Hospital in Moreland Road Coburg

    Monash Medical Centre (McPherson Private Hospital) in Clayton Road, Clayton

    Cabrini Malvern in Wattletree Rd, Malvern

    All hospitals have State of the Art facilities with first class Nursing Care. There are minor differences with regard to fees and out-of-pocket expenses, which you should discuss with my staff.

  • Will the sympathectomy have any impact on my feet?

    It is not uncommon for patients to have the combination of sweaty hands and sweaty feet. It is more frequent for the hands to be the more problematic, though this is not always the case.

    However, almost invariably I recommend treating the hands first, as this is more often the more troublesome, but also that in two thirds of patients, there is a significant improvement in the feet following a thoracic sympathectomy.

  • Is there specific treatment for sweaty feet?

    Absolutely. A lumbar sympathectomy (performed laparoscopically or by an open procedure) will interrupt the sympathetic nerve supply to the lower limbs, thereby cutting off the nerve supply to the sweat glands in the feet. Performed as an open procedure, it involves incisions on each side of the abdomen in order to approach the sympathetic chain. The operation takes approximately one hour, is performed under general anaesthesia, requires 2 to 3 days in hospital, and a 3 to 4 week recovery. The success rate is very high (greater than 95%), and complications are rare.

  • Why do I sweat so much from my armpits?

    You are not alone. Probably up to 2% of the population sweat uncontrollably.  When it affects the armpits, it is called axillary hyperhidrosis. This is a common area for excessive sweating, as there is a high concentration of sweat glands in the axillae.

  • What alternatives are there for treating excessive sweating from my armpits?

     

    Most will have tried the whole range of anti-perspirants, including the stronger Aluminium based agents such as Driclor, without success.

    Injections are effective, but provide temporary relief only, and therefore has to be repeated every 3 to 6 months.

    Sympathectic ablation (ETS) is a very good operation for many patients with hyperhidrosis. However for patients with underarm sweating (axillary hyperhidrosis), 20% will not achieve the result they were looking for, and there is a small but significant risk of rebound sweating or compensatory hyperhidrosis.

    We firmly believe that miraDry is the best option for patients with excessive armpit sweating or odour

  • What is miraDry?

    Your underarms account for less than 2% of your body’s surface area, so eliminating the sweat glands from that region will have no impact on the body’s natural cooling process.

  • Is miraDry surgery?

    This procedure does not involve any surgical incisions. Each treatment is customized for the person’s underarm area. It is performed under local anaesthetic, and is therefore generally well tolerated by the patient. Virtually all patients remain comfortable throughout the process.

  • Is there any downtime?

    There is minimal downtime after miraDry. We recommend over-the-counter pain medication and use of ice packs for a few days to minimize any pain or discomfort. We recommend a few days off work, and return to exercising only when pain-free.

  • How effective is miraDry?

    It is recommended that in order to achieve the best outcome, patients should under two miraDry sessions, spaced at least three months apart. We have found that 70 – 80% of our patients are satisfied after one treatment. Microscopic examination of skin biopsies show a 50 – 90% reduction in viable sweat glands following miraDry treatment.

  • Are there any side effects?

    Many patients experience some localized soreness and/or swelling in the armpit, which can extend onto the chest wall. This is transient and generally clears within a few days. Some experience more severe thickening in the armpit called banding which can last a few weeks. Less commonly, patients may experience short-term altered sensation in the skin of the upper arm.

  • How long do results last?

    Since the sweat glands do not have the capacity to regenerate, the results following miraDry are permanent.  Remember that If the desired outcome is not achieved after one treatment, these patients generally respond very well to a second miraDry session.

  • Is miraDry effective for body odour?

    MiraDry is also extremely effective in treating patients with body odour. In countries such as Japan, patients are more likely to have the procedure for odour rather than excessive sweating.

  • How long has North Western Vascular been using MiraDry?

    We began offering MiraDry treatment in October 2014 and became fully accredited soon after. North Western Vascular prides itself on being the leader in hyperhidrosis treatment offering exceptional service to patients.   To date we have treated over 350 patients with outstanding results.

  • Can you tell me about the results you are achieving?

    Patients are reporting a dramatic reduction in axillary sweating and odour.  Approximately 80% achieve the desired outcome with one treatment.  A second treatment is recommended for optimal results however only required in 20% of patients.

  • What attracted you to MiraDry?

    North Western Vascular was treating patients who suffered from  axillary hyperhidrosis with sympathectomy which required treatment in hospital, under a general anaesthetic. Although the results were very good following sympathectomy, a small number developed rebound sweating, which at times negated the benefit. On the other hand, MiraDry carries no risk of rebound sweating, can be performed under local anaesthetic in our rooms with virtually no downtime, no incisions and takes only 1 ½ hrs. Importantly success rates are high with MiraDry and the benefit is permanent.

  • What happens during MiraDry treatment? How does electromagnetic energy affect sweat glands?

    The procedure is done under local anaesthesia using an axillary template to precisely outline the treatment area.  MiraDry involves targeted microwave ablation of the sweat glands, destroying them permanently.

  • What is your protocol for treatment using MiraDry?

    The procedure is done by our fully accredited MiraDry Practitioner in our procedure room.  Local anaesthetic is used to numb the axilla, and also acts to protect the underlying tissues.  The presence of local anaesthetic means that the patient experiences minimal discomfort during the procedure.

  • Can MiraDry be used on other areas of the body?

    It can only be used for axillary sweating or odour. There is no approval for its use on other areas of the body.

  • What’s the average sweat gland reduction after treatment? Are results immediate?

    Histological studies show the majority of sweat glands are destroyed by the thermal injury imparted by the microwaves. From the patient’s perspective, there is a 50 – 90% reduction in sweating and the results are usually immediate.

  • How many treatments are required for optimum results?

    Generally patients will require one treatment on Level 5 however if hyperhidrosis is severe, then for optimal results a second treatment is recommended.

  • Will the destroyed sweat glands grow back after treatment?

    No, the sweat glands that have been destroyed during treatment will not regenerate.

  • Who is your typical patient?

    There is no typical patient as axillary hyperhidrosis can affect people of all professions and backgrounds.

     

    Generally patients we see have suffered from severe underarm sweating and/or odour for many years and have tried other forms of treatment such as Injections or heavy duty aluminium based deodorants which can cause irritation and only offer temporary relief. However, MiraDry is an exceptional treatment which is suitable for anyone who is bothered by underarm sweating and does not want to deal with the embarrassment of sweat patches under the arms.

  • Can it be used on all skin types?

    MiraDry is suitable for all skin types and there is minimal discomfort with this procedure.

  • What has been the feedback from your patients following MiraDry?

    The feedback from our patients has been extremely good with approximately 80% of patients having a dramatic reduction in underarm sweating of between 50 to 90%. Patients have reported renewed confidence and a sense of freedom following treatment as they no longer need to worry about wet patches or odour.   

  • Who can administer treatments with MiraDry?

    MiraDry can be administered by health professionals such as doctors or registered nurses.  At North Western Vascular both Mr Roger Bell and our Practice Nurse have been fully accredited by Miramar having undergone the required training.   Miramar have strict guidelines for administering MiraDry so the treatment has an extremely high safety record.

  • Do you think MiraDry has revolutionised hyperhidrosis treatments?

    MiraDry has definitely revolutionised hyperhidrosis treatment as patients undergo the procedure in 1 ½ hours with minimal downtime and unlike Injections which temporarily disable sweat glands requiring ongoing regular treatments, MiraDry offers a permanent solution as the sweat glands that are destroyed do not regenerate.   

  • How can I make an inquiry, book an appointment for consultation or MiraDry treatment?

    All enquiries and appointments can be made by calling 1800 SWEATY (1800 793289).  Our staff are knowledgeable and happy to help by providing information regarding treatment. Patients can book an obligation free consultation with Mr Roger Bell, hyperhidrosis specialist at any of our 4 locations across Melbourne.  Patients can also book directly for MiraDry after having received the required information.

Our Client Stories

I was driving home this morning feeling unimaginably happy. Choosing to have surgery was the best decision I’ve ever made. The first time I met you, I was overcome by how completely you understood what I was going through. I think what you do is unbelievably selfless and amazing. You have literally changed my life.

It isn’t even these major things that I am most grateful for. It is the much simpler things – going out to dinner without feelings of stress and anxiety, holding hands, getting my nails done… Read More

Before this operation, I wore gloves to job interviews, I skipped church to avoid the peace-be-with-yous as the thought of shaking someone’s hand made me cringe and my tops and dresses were always black to avoid stains from under my arms. This operation has changed my life forever, it has built my confidence up and has allowed me to take up new hobbies like dancing.

I just wanted to say a massive thank you to Mr Roger Bell and his team for allowing me to live my life sweat free… Read more

I was driving home this morning feeling unimaginably happy. Choosing to have surgery was the best decision I’ve ever made. The first time I met you, I was overcome by how completely you understood what I was going through. I think what you do is unbelievably selfless and amazing. You have literally changed my life.

It isn’t even these major things that I am most grateful for. It is the much simpler things – going out to dinner without feelings of stress and anxiety, holding hands, getting my nails done… Read More

Before this operation, I wore gloves to job interviews, I skipped church to avoid the peace-be-with-yous as the thought of shaking someone’s hand made me cringe and my tops and dresses were always black to avoid stains from under my arms. This operation has changed my life forever, it has built my confidence up and has allowed me to take up new hobbies like dancing.

I just wanted to say a massive thank you to Mr Roger Bell and his team for allowing me to live my life sweat free… Read more

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