Consultation: Quick 5-minute consult in-office. My NP has performed ~20 procedures so far, and told me pretty much all people can achieve dryness with miraDry. If you're an outlier (still wet after two procedures), a third procedure will still be effective. For the third treatment in this office, they manually take off the programmed decrease in microwave strength around the brachial plexus to increase efficacy. They also inject saline in this area, which has apparently been shown to reduce potential harm to these nerves. This answered all my questions. I chose to start at level 5 because I learned (from RealSelf) that this level had the best chance of permanent sweat reduction without much increased risk.
Procedure: Lidocaine injections were really no big deal - 2/10 on the pain scale. Here's where part of the "asymmetry" comes in. I felt a strong burning sensation in ~every~ upper portion (labeled "A") of the treatment area in my left arm, despite equal doses of lidocaine in both underarms. At worst, this got to a pain level of 6-7/10, but I could tolerate it and asked my NP not to stop. I felt nothing in my right arm. However, for my right arm, the suction came off about 4-5 times mid-radiation. This only happened once, minorly, with my left arm. Although the wand was held in place, I was afraid those areas did not receive the full treatment dose of radiation. From start to finish, the procedure took about 1.5-2 hours.
Recovery: Iced for two days, 600mg ibuprofen/6-8 hours for three days. Not only did my underarms swell, but also the upper 2/3 of my arms and my upper torso filled with water (edema). It has taken more than a week for 90% of that water to drain away. This was no big deal, though. The pain was minimal, at most a 3-4/10 the day after, but I tried not to touch my underarms for a few days.
Efficacy: "Asymmetry" again. This is where my experience strongly diverges from most people's and partly why I'm writing this review. I'm hoping for some commentary. My right arm (where the suction came up 4-5 times) started sweating two days after the procedure, and now (day 9) is probably back to 70% original level of sweat. I have regained total sensation in this underarm, and swelling is all but gone. (For reference, RealSelf reviews suggest that most people who start sweating immediately after the procedure do not end up achieving permanent sweat reduction following miraDry. Most normal patients achieve 100% reduction immediately, and sweat gradually comes back, plateauing at a lower level than what patients started at.) My left underarm, however, is almost not sweating at all. I would say there's a 95% reduction in sweating there so far, although I expect this to decrease over the next few months. A 4-inch diameter circle of this underarm is still entirely numb, although that seems to be decreasing everyday. It is generally more sore, and has more small, hard lumps underneath (which is pretty typical from other reviews I have read). There is also a slightly painful, stretching sensation under this underarm every time I elevate my arm above my shoulder, as if there is a rubber band within my armpit. Not sure what that's about, but I'm not too concerned.
Overall, I definitely plan on getting a second treatment - again at Level 5. I'm disappointed with the results in my right arm, and I wonder if it's because the suction came off so many times, or if it's simply indicative of the fact that miraDry won't work on me. I'd appreciate any and all commentary to this effect!