Results of videothorascopic sympathectomy in the treatment of facial redness and hyperhidrosis in 41 patients

To evaluate the results and complications of thoracic sympathectomy in the treatment of patients with uncontrollable blushing and facial hyperhidrosis. Between May 2000 and August 2006 we performed 82 VATS sympathectomies on 41 patients with the diagnosis of uncontrollable blushing and/or facial hyperhidrosis. Two of them had been previously operated on without good results. The technique employed was bilateral VATS sympathectomy varying the levels depending on the presence of palmar and/or axillary hyperhidrosis and the anatomical limitations. The results were evaluated one week after the procedure and 3-6 months later in 41 patients; and also one year later in 34 patients. Twenty-two men and 19 women, with mean age of 33.7 years (range, 18-56). In 17 patients (41.5%) main symptom was facial hyperhidrosis and in 24 (58.5%) uncontrollable blushing. All the patients were discharged before 24 hours after surgery, 14 of them in an ambulatory surgery program. There was improvement of the symptoms in all the cases of facial hyperhidrosis 17/17 (100%). In the blushing group the procedure was effective in 20/24 cases (83.3%). Results were good with the second surgery. Compensatory sweating was observed in 16/41 patients (39%), and was severe in 6 (14.6%). Sympathectomy is a safe and effective procedure in the management of facial hyperhidrosis and uncontrollable blushing. Compensatory sweating remains as the main secondary effect.