WIFH - Atlanta

WIFH doctors and staff are wonderful! I had smart lipo done and could not be more happy with my result. They are always on schedule, timely, pleasant, and courteous! Doctors took the time to consult with me in person prior to my procedure which made me feel much more comfortable and safe. Love them!

My story is probably similar to many people that have excessive underarm sweat. I was frustrated after trying every remedy available: prescription creams and anti-perspirants and even Botox injections to try and stop my embarrassing underarm sweat, but to no avail. I had read an article about miraDry, a simple procedure to reduce and in some cases totally eliminates underarm sweat and what I really liked was it was permanent. After much research I made an appointment for a consultation and my procedure at WIFH. I don’t live in Georgia so I was thrilled when I called to schedule and Melissa said they could do the procedure on the same day as my consultation, so convenient! Dr. Kulkin and his nurse practitioner, Charlotte, along with the entire WIFH staff are honest and truly the most experienced, professional team of people you will ever work with. I can’t say enough about them.

The Procedure:
After my consultation with Dr. Kulkin I signed my consent forms and got ready for the procedure. I have to admit I was a little nervous, but Charlotte, Dr. Kulkin’s nurse practitioner put me at ease. She is super friendly and knowledgeable; she explained every step during the process. She answered all my questions and kept me entertained for the next 1 hour and 45 minutes.

The procedure begins while lying down. I wore a sports bra so that I would be covered, but they did have a strapless gown had I forgotten. She measured each underarm and marked them with a marker. Then a stenciled temporary tattoo was placed within the marked area. Dr. Kulkin then came in to infuse the numbing medicine under the skin (they call the technique tumescent anesthesia). Now for me, I have a very high pain tolerance and honestly, I didn’t feel a thing. He gave me one shot of lidocaine in each underarm. Where the shot was injected is where he made a little puncture in the skin. Then he inserted a tiny little tube and moved it around my armpit to administer the numbing fluids and within a few minutes the whole area was completely numb.

Now that I was numb we were ready to start the procedure. The hand-piece looks like a small hair dryer. It suctions your skin up and delivers the microwave energy. Charlotte said she was using the highest power the machine allowed, but that wouldn’t be possible if they didn’t infuse the numbing fluid under the skin, people wouldn’t be able to tolerate it. I believe her because I felt absolutely nothing. I will say, that after about 10 minutes your arm does begin to feel uncomfortable from it being raised over your head and you aren’t able to move it during the procedure. I also started to shake a little and got cold. All of this was normal; Charlotte said it was from the lidocaine fluid. They did give me blankets to help keep me warm. After Charlotte completed the first arm (about 45 min) she gave me an ice pack to start icing the armpit she had just completed and she moved on to the other armpit. Another 45 minutes and I was done. She sent me home with two MiraDry ice packs so that I could continue icing off and on for the rest of the day.

After the Procedure:
It is highly recommended to ice your armpits for the next 24 hours for 20 minutes on 20 minutes off. This helps with the swelling and so I spent my entire day and night icing. The numbing started to wear off about 12 hours later and I did take Ibuprofen when I went to sleep. After 24 hours my armpits felt like it had a small bump (probably where they made the small puncture for the numbing fluid). It still hurt a smidge to lift my arms, but after 48 hours I was able to pick my 1 year old niece up without any problems. After a week, the swelling was almost gone but I still had one small bump in each underarm. It finally went away after about 3 weeks. All in all, I will say it is definitely worth it to get the MiraDry procedure. Thank you to Dr. Kulkin and Charlotte at WIFH! My armpit sweating has completely diminished and couldn’t be happier that there is finally a procedure that works for armpit sweating as well as for the smell. Now if MiraDry can find a way to help with my hands and feet sweat!!

I've suffered from excessive underarm sweating (hyperhidrosis) and underarm odor since I was a teenager. I sweat even when it's 30 degrees outside. I sweat when I am nervous and when I am not, I can be doing absolutely nothing, and I sweat. The odor that came along with it was just the icing on the cake. When I turned 30, I decided I had enough and couldn't live with this issue any longer. I live in Atlanta and went to WIFH to get treated by Dr Kulkin because of his anesthetic technique and I am SO happy I did!
I started out with a consultation with Regan. She was so kind and understanding and answered all my questions (and I had a ton). She made me feel so comfortable and I just knew I had chosen the right place and people to have my procedure with.
On the day of my procedure I met Charlotte, the Nurse Practitioner that performed my procedure. She was so nice too, just making everything very comfortable for me and explaining every step along the way.
Dr Kulkin came in to do my the numbing portion of the procedure. When I was initially researching this procedure I contacted other doctors that used lidocaine shots to numb you before the procedure. One told me that you could need several shots to get you "optimally numb", upwards of 100! I was already nervous about the procedure and knew being pricked 100 times per underarm wouldn't help. Which is why I chose Dr Kulkin. The numbing part was what I was most afraid of but it was so easy and quick! Dr Kulkin gave me one lidocaine shot per arm, then he made a small cut in my underarm and used this long device that he said delivered the numbing solution into my underarm. He used these back and forth motions while he was working and I felt some pressure but absolutely no pain. Each underarm took about 5 minutes and Dr Kulkin talked to me the whole time making sure I was okay. When he was done, my underarms felt super squishy and jiggly. One thing I will tell you is that the numbing solution made me feel very cold! Charlotte said it was from the epinephrine in the solution.
After the numbing part of the procedure we started the miraDry treatment. I couldn't feel a thing! It was incredible. I just talked to Charlotte and listened to my ipod and after an hour, I was done. My underarms looked a little swollen afterwards, Charlotte said it was normal and could last a week or two. I attached a few photos below of how my underarms looked after the procedure (and during).
For the rest of the day, I kept ice packs under my arms. Charlotte said this would reduce swelling. A few hours after that, I started to feel what felt like a sunburn under my arms. Charlotte told me to expect this and prescribed a Tylenol 3. Once I took that, I felt fine. Trying to sleep with the ice packs under my arms was hard so I actually didn't ice at night. The next morning I felt completely normal with no pain or sunburn sensation under my arms. And for the first time in 12 years, I wasn't sweating.
For those that don't experience sweating on a daily basis, you have no idea what this meant to me. It was unbelievable. I used to feel so dirty and uncomfortable because of my underarm sweat, I often took two showers a day.
I researched miraDry for a couple of weeks before I decided to have it done. I tried Botox once before but only went through two rounds of treatments because it was just so expensive. miraDry isn't cheap but when you compare it to Botox, it's definitely better to have one and done then ongoing treatments. Not only that, $2200 seems like a deal when you think about never sweating again. I'm three months out and very happy with my results. I'm upset I didn't do this sooner. If there is one procedure that is life changing, I think anyone that suffers from hyperhidrosis and has this done, can agree, this procedure is life-changing. I recommend this procedure for anyone that wants to end day-to-day suffering from sweating and odor.

I am beyond pleased with my results so far! I just had Juvederm injected yesterday, and although I'm still a bit swollen, I'm very pleased with the outcome.

The pictures posted are my before (top) and the morning after (bottom). I read lots of reviews on realself that most of the swelling will come the day after injecting, so I wasn't too surprised with how puffy I looked (thanks to the RS community, btw!) . I took some bromelain, arnica and a Zyrtec after the last pic was taken, and the swelling went down quite a bit. I have a little bit of bruising, but it's almost tucked into the inside of my top lip, so it's not that noticeable.

I had one syringe, splitting it between the lips and laugh lines (you can see the difference there, too!) I plan on taking baby steps in this process - I don't want too much of a change so soon. I'll probably go back in another 6 months.

MiraDry is a God-send! I'm 4 days removed from my procedure and completely sweat and body odor free! Dr. Kulkin's unique tumescent technique for numbing the underarm for this procedure was in all honesty, slightly uncomfortable during the application (2-3 minutes per armpit) but I can only assume the pain I could have experienced using the more common technique of multiple numbing injections under each arm. This technique however, allowed Charlotte (Dr. Kulkin's wife and a registered nurse) to utilize the miraDry machine at level 5 for the entire procedure with NO pain what so ever! If you are planning on having this procedure or even considering it, I encourage you to find a practice that uses the tumescent numbing technique and if you are in Atlanta please go talk to WIFH and Dr. Kulkin. Please also know that there will be some discomfort (the day of for me), swelling and bruising post procedure but the end result is completely worth the minor and I mean MINOR discomfort realized.
I truly believe this numbing technique accompanied with the level 5 application is the reason for my amazing results and would recommend this to anyone that has tried everything and is searching for relief!

Updated on 28 Dec 2015:
I'm now nearly 4 weeks removed from my procedure and I have nothing but positive things to say. I've had no change in my initial results which is to say I am completely sweat free in my armpits! I've experienced no relapse or regression that I read in some posts prior to my procedure. i'm not discounting those posts, I just have had 100% positive results from my experience. The swelling totally subsided somewhere around the 2-2.5 week mark. I also haven't experienced any of the lumps that others have experienced. Maybe I've just been very lucky but I followed the post procedure instructions as closely as possible and I think the initial icing regimen helped with my swelling and recovery. I'll post some photos soon.

Hey guys,

I've been browsing this forum for the past few months and have been so distraught with my tattoo decisions. Last semester I was feeling oddly on top of the world and I had reconnected with an old friend who happens to be a great tattoo artist. He wanted to hook me up with some work and since I already have tattoos on my forearm, chest, and legs I was like... "why not". Mistake 1. I went ahead and started getting work done on my left arm.. Then I decided to cover the old, outdated piece. Mistake 2. I hated it. It was suppose to be an inticate mandala but it didn't work so well and told him to fill it in black (stupidest words to ever leave my mouth). I hated the weight on the right on and never considered removal so I started working more on my left forearm. Mistake 3. ..

So it's been about five months now and I have been scouring all removal methods and have sunken into the darkest depression as I feel I have lost my approachability and professional appeal. My friends ask me why I don't hang out anymore and when I do they ask me why I've lost my smile. I have heard really terrible things from people that I respect and have heard some worse from strangers at the bar. Needless to say, the only thing I hear now is why I'm wearing a longsleeve shirt on a hot day.

I've decided I want them all off my body with the phrase "tattoo free by 2023". Haha. I understand that full removal of heavy blackwork is damn near impossible and all of this is going to take a very long time. I do realize the cost but if it means I can work towards being happy again, it's worth the world to me.

I have had a consultation with WIFH in Buckhead, Atlanta. The doctor there quoted me $150 a session for the heavy black mandala $215 for the entire other forearm. I guess I am just looking for opinions on this now. Should I do both treatments at once? Should I do the heavy work first then go back two weeks later? I'm very scared and anxious. I've heard of scarring, thyroid cancer, and just bad stories from tattoo removal.

I know that Karo Sumi ink was used minimally in both pieces and not sure about the other inks used.

Updated on 17 Apr 2014:
I recently discovered that laser tattoo removal should not take place within three months of taking St. John's Wort (the natural antidepressent I've been taking since I realized my mistakes). So I have to wait this period out and summer is around the corner. I couldn't tell you the amount of anxiety and hatred I've built up knowing this. I'm at the point of considering another loan to skin graft the area of heavy black because that's what's been eating me. Any thoughts towards a skin graft for such a large area? I feel my patience will break soon and oh man... it hurts to the core. :(

Updated on 24 Apr 2014:
So I've decided to settle with River City Tattoo Removal in Chattanooga, TN. Adam, the guy running the shop is currently removing his sleeve and says that we can rid mine in 12 treatments with 6 months free after if I'm not satisfied. He is quoting me at $275 for the entire piece that will be treated in halves to prevent blood flow restriction. He said to come back every six weeks to do the other half. I am wondering if there is any way cut that time in half? Is it safe to laser the remainder after this amount of time? Who knows..

I suppose I'll try to get in pretty soon. It's going to take so dang long. Sigh.

Updated on 18 Jun 2014:
So, I went in for my first treatment on the heavy black work today. Used the Revlite SI laser and it took maybe 3 minutes top to do. There was pain (obviously) but it was super bearable and kinda made me laugh. Haha. Anywho, I'll be posting photos in a few days.

Easy

Updated on 18 Jun 2014:
Sorry for the shoddy quality, but here is a snippet of the treatment.

I have an ankle tattoo of a butterfly (about 1 square inch). I started laser treatment in August of 2011. I completed five treatments at one clinic through September 2012. After that, I switched clinics and have completed three treatments there (last one was on 4/9/13). So eight total treatments all together. The first clinic used one laser to treat the whole tattoo. The new clinic uses different lasers to treat different colors. They treat the color every other visit (so black one visit, color the next, etc.).

Pain: For me, it feels like razor blades dipped in fire and acid are being slowly dragged across my ankle (not to be too dramatic). I have to give myself a pep talk before going in the clinic doors. There is very little fat in your ankle so I think that makes it even worse. Did it hurt more than getting the tattoo? I’m not sure, the tattoo was 17 years ago and the memory of the initial pain is long gone. I will say the pain was much higher at the first clinic I went to for treatment. The whole session takes less than a minute, but wow, it is a long minute. I’ve never tried numbing cream. They have this cold air they blow on my ankle before and during the treatment at the new place. I’m not sure how much that helps. They also give me these stress balls to squeeze during treatment and I have to remind myself not to throw them at the tech’s head to make her stop. Because one time I did ask her to stop and she just kept going. She told me afterwards that it was better for me if she didn’t stop and start because it was so quick. Hmmm, easy for her to say!

Healing: At the first clinic, I would have pinpoint bleeding for at least two days. The tattoo would then scab over with a lovely, crispy looking black layer that would last about a week. I was super excited at first wondering what my tattoo would look like after the black scab of doom came off . . . only to have it look about the same. At the second clinic, I had redness after the first two treatments, but no bleeding. After my most recent treatment, I had redness and a big, bulging blister that developed in the center. The blister has finally started to go down after 9 days, but is still there. They treated the color on my most recent visit so we’ll see how the red color looks after the blister is gone (the red has stayed pretty vibrant throughout all treatments). I will add a picture once it is healed. It’s impossible to shave close to the tattoo while it was healing so when I take a picture before it is healed, it magnifies any hair by the tattoo and makes me look like I am some hippy that doesn’t shave.

Cost: $99/session at first clinic, $175/session at new clinic.

I am almost at the two year mark for treatments and there has been some fading, but definitely not what I hoped for after two years. It still definitely looks like a butterfly. So about a thousand dollars in, a lot of pain, and not much difference. I think the best solution is to keep throwing money at it. At this point, I’m hoping for a little more fading, but have accepted that it is probably not going to be removed completely. I should have listened to my grandma 17 years ago – she told me I would regret it one day.

Also if you go through airport security after a tattoo removal treatment with a bandaged ankle, they take you to a special room for a security screening. Apparently a bandaged ankle can flag you as a suspected terrorist.



Updated on 19 Apr 2013:
Added a new photo showing the difference after the last treatment. It is still healing up a bit, but it's showing good progress.

Updated on 5 Jan 2014:
It's been a while since my last laser treatment. Had one on Friday. I am posting a picture of what it looked like right before treatment next to how it looked after the first treatment. I think there might be some scarring that I am noticing after all the treatments, but it is fading well.

My last treatment on Friday did not hurt as much as previous treatments. They treated all the colors and the black outline this time. Normally they just treat the colors one visit and the black on the next visit. I am posting a picture of how it looks two days after treatment. It looks even worse in person. I am a little worried because I have never had this kind of blistering before. The redness extends well beyond where the tattoo ends. I know a lot of people experience blistering, but I thought this was more common in the beginning of treatment and less so as time went on.

Initially visited WIFH for laser services, but I had heard about the MiraDry procedure and I was interested in it so I inquired and ended up purchasing both treatments the same day. They didn't inform me that day of my initial visit and full payment which was required that some medications interfere with the efficacy of MiraDry.

The day of my MiraDry procedure I signed a consent and release that did disclose this information, but by that time the full amount I had been required to deposit was non refundable so I figured I would go ahead with the treatment since I would lose the money regardless. The treatment provider was delightful, she is married to the doctor that owns and operates WIFH, and she talked the entire time which distracted me effectively from discomfort and I was thankful for that. I was cautioned by the physician that I would likely have a large amount of swelling, but OMG I never, in a million years would have expected to swell as much as I did nor for it to remain as long as it did. I wouldn't look at myself in the mirror when I got out of the shower I was soooo swollen for weeks after the procedure. The bruising was remarkable as well even though they said if I iced as they instructed it would be minimal to none. Which was anything but the case I assure you. Honestly I felt fat and gross for around a month after the treatment and couldn't bear to look at my body in bathroom mirror and had to wear loose fitting tops because of the "fat" rolls, which were actually just the injected fluid and swelling making its way down my body over the weeks post treatment) at my waist above my pants.

The first 2 weeks post treatment there was no perspiration under my arms and I thought perhaps these extended, but temporary side effects would be worth it. Not having to put on anything under my arms yet no perspiration or odor being present was welcome and delightful. 2-2.5 weeks post treatment my underarms began to perspire and each day seemed to be a greater amount. So I began wearing deodorant/anti perspirant again.

In the end nothing has changed about my daily routine as I must still put on deodorant/anti perspirant every day to avoid perspiration and odor. If I had to do it over again, I would keep the 2k I invested (and wasted in my opinion). No one followed up with me from WIFH concerning the treatment results, but I did mention the ineffective treatment to the laser provider I continue to go to there and she said I could have MiraDry performed again at a reduced cost and that may improve the results, but I don't think I would want to go through the discomfort during or after the procedure nor the excessive bruising and swelling. I would go so far as to describe the bruising and swelling as "insane" as it was to that degree in my observation and opinion, and it's effect on my self confidence and overall feeling of well being for the month after the treatment was similarly negative. I would not allow my husband to so much as see me naked for this time frame and would also draw away from him when he touched my body. Needless to say, this was a problem for him in our relationship and myself as well.

If others find MiraDry to be effective I am pleased for them, but my experience was not a good one during or after treatment and I wish WIFH would have disclosed the medications that interfere with the efficacy of treatment before I signed up and paid the non refundable full payment which was required up front when making appointment.

I still go to WIFH for laser services and really like Mrs. Flash that performs these services for me there, but I wouldn't go there for anything else and the front desk staff seems to have a bit of an attitude in my observation and experience at each visit... I would describe it as quiet assessment with a bit of a chilly reception to the guests; certainly not warm nor engaging, but not rude or unkind either.