Is the tumescent technique the protocol for Miradry?

Yes, this is the preferred protocol.  As others have pointed out, the tumescent technique is currently recommended for Miradry. The goal is to use of a large volume of weak local anesthetic (tumescent) to create more physical distance between the treatment head on the sweat glands and the underlying deeper structures. The fluid also acts as a "heat sink" to absorb any excess heat in the area. All this allows for a more comfortable treatment at higher treatment settings with better reduction of sweat and less risk of post-treatment side effects such as numbness.

The recommended numbing protocol is to use the tumescent solution. This will ease the discomfort related to the treatment and will protect the underlying structures such as nerves. Using the tumescent allows your MiraDry provider to treat at a higher level setting as well.

Yes, using tumescent in each of your underarms is the preferred technique for numbing or anesthetizing the area.  It also protects the deeper structures in the area to minimize risk of injury to these structures.

Tumescent lidocaine is one protocol that is used in treatment as the panel has laid out.  The justification for tumescent lidocaine is to provide a larger distance between underlying structures and the targeted pilosebaceous units.  MiraDry can be painful due to collateral heat and theoretically this can reduce the risk of nerve injury from microwave heating.  Prior to receiving treatment I would recommend asking your provider what protocol they utilize and why.  The tumescent lidocaine protocol is considered to be safer and more comfortable with few side effects (e.g. edema of local tissue).

Yes, this is the new protocol. Better results and more comfortable. It's also safer for the deeper tissue. 
Best wishes, Dr. ALDO 

Thank you for your question. We use 50mL of Lidocaine mixed with 10mL of Sodium Bicarbonate. This is diluted into 250mL of 0.9% Sodium Chloride and injected via spinal needle into your underarms. It is very effective in numbing without any pain. Usually patients require about 100-120mL of the tumescent per underarm. Hope this helps!

It is necessary to make the treatment more comfortable.  We have worked with different combinations to make it very comfortable.

We are using the tumescent technique with virtually all of our Miradry patients, using a 2 inch cannula. It's definitely the safest way to go, especially in patients who are thin and have thin tissues. Good luck!

Thank you for your concern
Tumescence is necessary otherwise the treatment at high energy is not possible.
Good LuckGD

Tumescent anesthesia is definitely the best approach for using MiraDry.  It is much less painful for the patient.  I would not perform the procedure any other way.  Take care.Timothy A. Janiga M.D., F.A.C.S.