HYPERHIDROSIS AND FACIAL BLUSHING
HYPERHIDROSIS AND FACIAL BLUSHING
A cure for severe hand and feet (plantar) sweating and for Social Phobia
DR. JOAQUÍN GARCÍA-MORATO offer a “State of the art” ETS, ETS(c) as well as the “Reversal” surgery performed for one of the most experienced teams at a very convenient price/quality ratio, for both hand and/or feet sweating and Social Phobia or Facial Blushing.
About the Surgery for hand Sweating
Thoracic Sympaticothomy or Sympatectomy (ETS or ETS©)
We have a program for surgical treatment of Hyperhidrosis, pioneer in Latin America since 1995. The procedure is performed on an outpatient basis (6hs. in the clinic), or as an overnight stay. General anesthesia with an endotracheal tube is used. The thoracic cavity is entered under the armpit with an optic through a 1 cm incision. The sympathetic nerves are cut or clamped by applying removable titanium clips through a second 5 mm skin incision next to the previous one. Both sides are operated on under the same anesthesia. The clip application, as opposed to the diathermia cutting, makes the procedure “potentially reversible” if excessive sweating of the trunk appears after surgery. We have been using the clipping method since 2001, and up to now just one sigle patient has asked to have the clips removed. Patient selection for surgery is key for good results.
Compensatory sweating is an excessive sweating on the back, abdomen, thighs, and/or lower legs after surgery. This should be expected to a certain degree in 50% of the patients. Compensatory sweating is not constant. This is likely to happen in hot and humids environments. Those who sweat from the trunk prior to surgery are more prone to get severe compensatory symptoms following surgery.
A modest decrease in heart rate (approximate 10%) at rest and during high exercise demand may be experienced in some patients. If it occurs, it has no physiologic consequences.
Some patients (15 %) can experience increased sweating in the head and neck area while eating or smelling spicy food (gustatory sweating)
No operation is without risks. Complications are not common in ETS surgery. Potential complications may include the following:
- Injury to surrounding organs
- Neuritic pain
- Anesthesic complication
- Horner syndrom
Contraindications for surgery
Severe previous or current illness (particularly cardio-respiratory or pleural disease) could be a contraindication for the procedure (See preoperative test).
About the Surgery for severe feet Sweating
Lumbar Sympathicotomy or Sympathectomy
The surgery is done under general anesthesia. The retroperitoneal space (lumbar) is entered with an optic through a 2 cm incision. Two additional 0,5 cm skin incisions are needed. The sympathetic nerve is remuved. The proceeding takes 60 to 90 minutes each side. Generally, both sides are operated on under the same anesthesia. We perform the lumbar operation as an overnight basis. Generally ladies are much more interested in the cure of feet sweating.
Compensatory sweating is a potential risk and should be expected to a certain degree. It is not as usual as for ETS.
No operation is without risks. Complications are not common in this surgery. Potential complications may include the following:
- Injury to surrounding organs
- Neuritic pain
- Anesthesic complications
How to arrange the surgery. Practical aspects
All previous arrangements can be done by e-mail, Skype or telephone. We will ask you to fill out a preoperative questionnaire that will allow us to know more about you. Before we schedule your surgery, you need your preoperative test done. We schedule surgery 2 to 4 weeks in advance.
For foreign patients living abroad, we usually proceed as follows:
Day 1 – Consultation and examination with the doctor. You’ll get an individual, written treatment plan with a medical consent.
The Surgery will be done at “Clínica del Sol”. After surgery you will be monitored for 4 to 6 hours in the outpatients facility before leaving the Clinic.
Day 2 – Postoperative control at the Doctor’s office and check out. You can travel home back or you can spend some days enjoying our country. www.buenosaires.gov.ar – www.argentina.gov.ar.
In order to have surgery as an outpatient basis (the patient spends about four to six hours in the recovery room and then is able to return to his hotel/apartment), we recommend coming with somebody else (a relative or friend). If you come alone, we recommend that you stay overnight in the Clinic.
Who performs the surgery?
Dr. García-Morato himself performs all the procedures (more than 650 Simpathicotomies), with the collaboration of a second surgeon, the anesthesiologist and the scrub nurse. In the operating room there will also be a cardiologist and nurses.
Where is the procedure performed?
The surgery is performed at the Clínica del Sol, a state-of-the-art facility, in Recoleta neighborhood. It is about 25 block from Buenos Aires down town. www.cdelsol.com.ar
How long does it takes to return to normal activities?
Return to daily activities or work can be accomplished in 2 to 3 days.
Do the clamps set off alarms in airport metal detectors?
The titanium clips will not set off any metal detectors.
It is possible to know in advance who will have compensatory sweating?
No. Those who sweat from the trunk before surgery have more chances of having compensatory sweating. It doesn’t mean that those who don’t sweat from the trunk before surgery have no risk of compensatory sweating.
What is the cost of ETS©?
There is an inclusive charge that covers the facility, anesthesia, and the surgical fees. After receiving your preoperative questionnaire, we will be able to inform you of the total price of ETS© surgery.
Dr. Joaquín García-Morato
- 1980 M.D. Buenos Aires University
- 1982-85 Resident. General Surgery. Buenos Aires University
- 1987-88 Resident. Thoracic and Vascular Surgery. Avignon, France
- 1986 Argentinean Board in General Surgery. Buenos Aires License
- 1988 Argentinean Board in General Surgery. Argentine Association of Surgery
- 1991/Present Teaching Position. Thoracic Surgery. Buenos Aires Medical School
- 1993 Argentinean Board in Thoracic Surgery. National Healthwellfare
- 1993 Recertification – Board in General Surgery. Argentinean Association of Surgery
- 2000/Present Chief Thoracic Surgery. Institute of Medical Research, Buenos Aires University
- 2003 Member of International Society of Sympathetic Surgery
- 2004 Member International society of Hyperhidrosis
- 2004 Recertification – Argentinean Board in Thoracic Surgery. Argentinean Society of Thoracic Surgery
- 2010 Chief Thoracic Surgery. Institute for Medical Research A. Lanari. Buenos Aires University
- 2017 Chief. Division of Thoracic Surgery. Hospital de Clínicas. Buenos Aires University.
Articles about Hyperhidrosis and Eritrophobia
National and International (Resumé)
- “Primary Craneofacial Hyperhidrosis. Surgical Treatment”. Medicina Vol.60, Supl. 1- 2000 pag.123.
- “Argentinean Experience from a Single Surgical Group in Endoscopic Thoracic Sympathicotomy”. Clinical Autonomic Research 2003, 13:158
- “Hemodinamic and Gasometrical Changes during General Anesthesia for sympathicothomy”. Clinical Autonomic Research 2003, 13: 160
- “Gasometrical Changes during Bilateral Thoracoscopic Simpathicotomy”. Archivos de Bronconeumología, Vol. 40, Sup. 4 – 2004, pag.113.
- “Primary Palmar Hyperhidrosis. Surgical Treatment in 172 Patients”. Medicina Vol. 66 (Supl I), 2006, pag. 54
- “Arterial Oxigenation during Bilateral Toracoscopic Simpathectomy at T2-T3 Level” Medicina Vol. 68 (Supl. I) 2008, pag. 45.
- “Videothoracoscopic Simpathectomy in Severe Vascular Disorders of the Upper Limb” Medicina Vol. 68 (Supl. I) 2008 pag. 62
- Second Inernational Symposium on Thoracoscopic Sympathicotomy. Boräs, Suecia, 1997.
- “Sympathectomy in Hyperhidrosis”. Speaker. Argentinean Congress of Dermatology. Buenos Aires, 1998
- Speaker: “Surgery of primary Hyperhidrosis”. II International Symposium. Proceedings in Surgery and Dermatology. Buenos Aires, 1998.
- “Surgery of Social Phobia”. Speaker. II Symposium. Argentinean Society of Anxiety Disorders. Buenos Aires, 1998
- “Results of Surgery in Primary Hyperhidrosis. II Symposium. Argentinean Society of Anxiety Disorders. Buenos Aires, 1998.
- Speaker: “Sympathicotomy in Primary Hyperhidrosis”. Annual Course of Pediatric Dermatology. Ramos Mejía Hospital, 1999.
- Speaker: “Primary Craniofacial Hyperhidrosis. Surgical Treatment”. 8° International Congress of Internal Medicine. Hospital de Clínicas, 2000.
- Attending: “5° International Symposium of Sympathetic Surgery” Erlangen. Germany 2003.
- Speaker: “Argentinean experience from a single surgical group in endoscopic thoracic sympathicotomy”. 5° International Symposium on Sympathetic Surgery” Erlangen. Germany 2003.
- Speaker: “Hemodynamic and gasometrical changes during general anesthesia for sympathicothomy”. 5° International Symposium of Sympathetic Surgery. Erlangen, Germany 2003.
- Speaker: “Surgery of the Autonomic Nervous System”. Workshop. Hospital de Clínicas. Buenos Aires, 2004
- Attending: “6° International Symposium of Sympathetic Surgery”. Vienna, Austria. 2005.
- Course: “Thoracoscopic Reconstruction of Sympathetic nerve” Vienna, Austria, 2005.
- Presentation: “Bilateral Thoracoscopic Sympathectomy with single lumen endotracheal tube in Palmar Hiperhidrosis”. South American Congress of Thoracic Surgery. Concepción, Chile 2005.
- Speaker: Surgical treatment of somatic manifestations of Anxiety Disorders. Regional meeting World Psythiatric Asociation .. Buenos Aires 2006.
- Speaker: “Primary Palmar Hyperhidrosis. Surgycal treatment in 172 patients”. 11° International Congress of Internal Medicine. Buenos Aires 2006.
- Chairman “Anesthesic Proceedings in Sympathectomy”. 7° International Symposium of Sympathetic Surgery”. Recife, Brazil. 2007.
- Attending: 7° International Symposium of Sympathetic Surgery. Recife, Brazil 2007.
- Training: Lumbar Sympathectomy for plantar Hyperhidrosis. Merano and Brescia, Italy 2009.
- Training: Reconstruction “reversal” of Thoracic Sympathetic Nerve. Merano and Brescia, Italy 2009.