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Is it safe to have a miradry treatment for hyperhidrosis after a mastectomy with axillary lymphnode dissection (+radiotherapy)?

Is there an increased change of lymphedema?

Doctor Answers 6

MiraDry and breast surgery

MiraDry after breast reconstructive surgery and axillary surgery should be safe. I would preface this response with the need for a physical exam. If there is not enough tissue between the skin and the underlying axillary content such as the arteries and nerves and veins, then one should avoid this or add a considerable amount of tumescent anesthesia solution.  If there is a lot scar tissue and fibrosis, then one may want to consider fat grafting as a separate procedure to provide more softness and fullness to the axilla. I would definitely consult with a board-certified plastic surgeon who does MiraDry treatments in their practice for a full consultation

Not worth the risk

First of all, congratulations on completing a mastectomy and axillary node dissection along with radiotherapy. It sounds like you are on your way to being healthy and cancer-free in 2015. I think miradry is an incredible way to stop axillary hyperhidrosis, and rarely are there contraindications. However, in your case, I think it is wise that you're asking such a question prior to having the procedure performed. Though it is not directly contraindicated in patients like yourself, there also haven't been enough studies done to determine the safety and efficacy. As you know, very small disruptions to the lymphatic system in someone with a node dissection can cause difficult-to-manage lymphedema. This edema can be severe enough to cause disfigurement and functional impairment. It is easier to prevent than to treat. Therefore, I would recommend against this procedure for you. Again, it is not directly contraindicated, but it is my professional judgement that this may be un-necessary risk. Instead, consider Botox, which is a great (albeit temporary) alternative. Best of luck to you! Sincerely, Dr. Cameron Rokhsar & Molly Murray, PA-C 

Cameron Rokhsar, MD
New York Dermatologic Surgeon
4.5 out of 5 stars 33 reviews

High risk - try BOTOX first

You are spot on with lymphatic drainage and scar tissue. Electromagnetic energy may be dissipated to the scar tissue and may not work as well, additionally the chances of prolonged swelling is magnified enormously- you may have swelling that last of months and you may need postural lymphatic massage. 

If you came to see me for miraDry, I personally would say lets try BOTOX first- far safer in your case, but still over 90% effective. 

In Australia, Botox for excessive underarm sweating is only around 380 USD out of pocket, as it is subsidised by the government. 


Dr Davin Lim
Brisbane, Australia

Davin Lim, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 9 reviews

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While it is not listed as an absolute contraindication, there could be significant swelling from the MiraDry.  Since patients with your history do not usually have normal lymphatic flow in that area, the swelling may not drain normally and could even cause more problems like skin breakdown.  Also, it may be hard to tell whether any persistent lumps or bumps in the armpit (axilla) are from the MiraDry or could be a recurrence of the cancer.  In my opinion, this treatment would not be recommended with your history.

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Rarely is a miraDry sweat reduction treatment a problem.

Although I absolutely believe in the treatment, miraDry, to dramatically reduce sweating there are a very few people who should avoid it.  Unfortunately, significant surgery and/or readiotherapy to the are to be treated (the armpit) is a reason to avoid treatment.  May I suggest a consultation with your dermatologist for Botox.  It works very well, should not be a problem with your situation and is easy to have done.  The downside is that it lasts, on average, 6.7 months so you will need to keep up the treatments.  Be sure to check with a qualified physician before having any treatments in that area.

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MiraDry after axillary node dissection - don't recommend

I would say yes there would be - I have expertise in this area as I have Board Certification from the American Board of Venous and Lymphatic Mediicine and I also perform miraDry and have done so since 2011. I would recommend that you not get it as it may well increase lymphedema in your arm. Read my miraDry book. I would recommend that you take bioflavonod formula called Lymphedema Fighter to help reduce lymphatic swelling for which you are at hgiher risk. It is available form 

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