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

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

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