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Hyperhidrosis Surgery
ETS Treatment for Excessive Sweating, London

Endoscopic thoracic sympathectomy (ETS) — a highly effective keyhole procedure for primary hyperhidrosis affecting the hands, armpits, or face. Over 95% success rate for palmar sweating. Most patients home the same day or the following morning. London Bridge Hospital and Lister Hospital Chelsea.

What Is
Endoscopic Thoracic Sympathectomy?

Primary hyperhidrosis is caused by overactivity of the sympathetic nervous system. Endoscopic thoracic sympathectomy (ETS) is a minimally invasive keyhole procedure that interrupts the relevant segment of the sympathetic chain through a single small incision in the armpit, performed under general anaesthesia.

ETS is most effective for palmar (hand) and facial hyperhidrosis, with published success rates above 95%. The effect is typically immediate — patients wake from surgery with dry hands for the first time in their adult lives.

The main side effect to discuss is compensatory sweating — increased sweating elsewhere on the body, most commonly the trunk. This is mild and acceptable in the majority of patients, though it can be more significant in some. All aspects of the procedure, including risks and realistic expectations, are discussed fully at consultation before any decision is made.

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Types of Hyperhidrosis Treated
  • Palmar hyperhidrosis (excessive hand sweating)
  • Axillary hyperhidrosis (excessive armpit sweating)
  • Facial hyperhidrosis and facial blushing
  • Combined palmar and axillary hyperhidrosis
Procedure & Recovery

ETS is typically performed as a day-case or with a single overnight stay. The procedure takes approximately 30–45 minutes under general anaesthesia. A single small incision is made in each armpit. Most patients return to desk work within 3–5 days and to physical activity within 2 weeks.

Insurers Accepted

BUPA, AXA Health, Aviva, WPA, Cigna, and BUPA International. Please contact Grace Jones to confirm your specific cover: 020 7952 2882.

Questions About
Hyperhidrosis Surgery

Below are the questions patients most commonly ask about ETS surgery for hyperhidrosis.

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Is ETS surgery permanent?
Yes, in the vast majority of cases. ETS involves dividing or clamping the sympathetic nerve fibres, which produces a permanent effect. The improvement in palmar and facial sweating is immediate and lasting. Unlike Botox injections, which require repeated treatment, ETS is a one-time procedure.
What is compensatory sweating?
Compensatory sweating is increased sweating in other areas of the body — most commonly the trunk, back, or thighs — that occurs as a result of ETS. It is experienced by the majority of patients to some degree. In most cases it is mild and acceptable, particularly when weighed against the improvement in palmar or facial sweating. In a minority it can be more significant. This is always discussed in full at consultation before any decision to proceed.
How quickly does the effect occur?
The effect is typically immediate. Most patients wake from surgery with dry hands for the first time. The improvement in facial blushing and sweating is equally rapid.
What is the recovery time?
Most patients go home the same day or the following morning. Return to desk work is typically within 3–5 days; light physical activity within 1–2 weeks. General anaesthesia is required, so you will need someone to take you home and stay with you on the first night.
Do I need a GP referral?
No. Self-referrals are welcome for private consultations. Appointments are typically available within 2–3 days. No GP letter required.

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Appointments within 2–3 days. Self-referrals welcome. No GP letter required.

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