Is The ETS Surgical Procedure Appropriate for Facial Sweating and blushing?

In the early 90’s ETS was thought to be an answer for patients who suffer from facial blushing and or facial hyperhidrosis. The basis for this was the fact that patients who had facial blushing and or hyperhidrosis together with palmar hyperhidrosis (excessive hand sweating) showed an initial improvement of the symptoms in the head region.

That lead to the assumption that ETS would help patients who suffer from facial sweating and or facial hyperhidrosis. It was then adopted by surgeons in Europe and the Far East to offer ETS as a solution for these facial conditions.

As more information came to light, it was shown that patients who had the operation for facial presentations developed more severe side effects in regards to compensatory sweating, gustatory sweating and hair loss.

After reviewing those cases Dr. Reisfeld decided not to offer ETS for those two isolated types of facial hyperhidrosis. The theory is that, while performing ETS for facial problems, the surgeon must be high in the sympathetic chain. This causes less sympathetic ganglia to supply the head region, thus causing severe side effects.

By performing ETS on lower levels of the sympathetic chain (T3 to T4) you allow the head area to get more in-tact sympathetic innervation which helps with the side effects.