MiraDry - should I get 2nd treatment after experiencing severe pain and nerve damage the first time?

I would discuss with your doctor if he or she thinks a second procedure is warranted.  The new protocol with tumescent fluid took the risk of nerve damage to basically zero.  We do the most miraDry treatments than anyone in California.  Let us know if we can help.

Our office specializes in Miradry procedures in Los Angeles. If you are experiencing problems with the treatment, we would not recommend a redo procedure. Instead, speak to an experienced surgeon who utilizes the system for a second opinion. Raffy Karamanoukian MD FACSLos Angeles

I have had patients who have had numbness in their arms for a prolonged period of time on the order of months. This is typically return to normal. You will probably be fine with the second treatment of me are dry. You may want to see what the settings were in either hold the same setting or go lower.  Going lower may however result in a need for a third treatment if you are still having breakthrough sweating.  I would also make sure that you do a sweat iodine test on your second pass. This may help to target and refine your treatment pattern for your second treatment.

A lot of study has been done on the best and safest way to use miraDry to treat armpit sweating.  A new protocol has been developed that changes the way local anesthetic is used for the procedure.  The same type of local anesthesia used in liposuction (called tumescent anesthesia) is now commonly used for miraDry.  It uses dilute lidocaine (the anesthetic) in a large volume injected under the skin of the armpit.  This serves as a cushion between the sweat glands and underlying nerves. The result is a very comfortable procedure with very low risk of injuring underlying nerves. The effectiveness of the treatment is increased because higher energies can be used with more safety.  

My partners and I do lots of MiraDry treatments and I am currently conducting a study for the MiraDry manufacturer regarding treatment pain management using tumescent anesthesia for prior to these treatments.  We always use tumescent local anesthesia prior to treating our patients and achieve a very easy and comfortable treatment for most of our patients.  In addition, this type of anesthesia is associated with less bruising.  Over two years ago, when we first got our device, we treated our patients at Level 3, and we now treat everyone at Level 5 for two consecutive treatments three months apart.  We found that Level 3 or less was inadequate to achieve our goal of 80% improvement in the hyperhidrosis, and we had more patient complaints with Level 3, 4 or lower.  We have consistently used level 5 for the past year, safely, without significant adverse effects, and better results with fewer people needing third treatments.  In addition, we believe it is common to have peripheral nerve irritation and injury with MiraDry treatment causing persistent numbness in the armpits following treatments.  We have seen the mild nerve symptoms continue on average for 3-6mths and then resolve.  Peripheral nerves are fortunately quite resilient and usually regenerate and recover.  All our patients who experienced nerve symptoms reported that it was not bothersome.   

If you had nerve injury with level 2 I would cauthion you not to enroll for another treatment. The surgeon/provider can use another type of anesthesia (in addition to local) that can help reduce this likelihood. I use that technique on every case and it is proprietary. Read my miraDry book on the link below - it is free.