The decision to operate for these distressful conditions must be weighed up against the risk of the potential complications and side effects associated with surgery. This can only be decided on an individual basis. Traditionally ETS surgery is irreversible as the cut nerve does not regrow. However there are new techniques which involve clipping of the sympathetic nerve. This may have some potential benefits if the side effects are too severe as ETS can then be reversed successfully in 20-30% of cases. ETS surgery is contra-indicated in patients who are obese or who have suffered from significant chest disease.

Contraindications to Surgery
This procedure is not indicated in elderly patients or patients with cardio-respiratory disease or who have had previous chest surgery.

Conventional ETS Surgery
This is "key hole" surgery. This procedure is performed under a general anaesthetic. Two small cuts are made in each armpit 0.5cm in diameter. The sympathetic nerve is divided. The wound is closed with dissolvable sutures. The scar is minimal. The procedure lasts approximately 40 minutes. A post operative chest X-ray confirms full lung expansion.

New Technique for ETS Surgery
This technique can be reversed. Clipping of the sympathetic nerve has been shown to be as effective as conventional ETS surgery in stopping blushing and sweating. It has the advantage in that it can be successfully reversed in 20-30% of cases should it be clinically indicated. the only reason to reverse the surgery is if the side effects are too severe (see results).

Post Operative Course
Often there can be some sharp pain around the wounds and sometimes the upper back, although this soon wears off. Return to work can be as little as 2 days post surgery, but the time can vary depending on the individual. Return to sporting activities can take up to two weeks.