The most common side effect of sympathectomy is called compensatory sweating. This is defined as exaggerated sweating, which may occur in the lower chest, the back, abdomen, thighs, and legs. This may also be accompanied by sensitivities to heat or cold. The majority of patients undergoing sympathectomy will experience some degree of compensatory sweating. The extent of compensatory sweating is variable and unpredictable prior to surgery. It may present as very little moisture to frank sweating. It usually occurs in hot weather.

It is known that CS is related to the extent of sympathectomy. The greater the area of denervation by sympathectomy, the more severe CS. The older methods of sympathectomy involved removing or eliminating a large segment of the sympathetic nerves which would result in severe CS. Fortunately with the newer ESB methods the extent of sympathectomy is minimized and level of sympathectomy is tailored to the specific type of hyperhidrosis or facial blushing. This new technique has substantially reduced the severity of CS.

The majority of patients are content with some degree of compensatory sweating if their original condition, hyperhidrosis or facial blushing, is cured. However a small number of patients experience extreme and troublesome compensatory sweating after having surgery. For those patients with severe CS, the titanium clamp could be removed in order to reverse the surgery. If the titanium clamp is removed soon after the surgery, there is a good chance that the surgery may be reversed and CS would be decreased or eliminated. However this has to be done soon after surgery since after a few months, the chance of reversal diminishes.

Medications also exist to treat CS. These include Robinul and Ditropan. Both of these drugs have been used to treat CS successfully.

Other side effects and complications of the surgery include possible bleeding, infection, nerve damage, postoperative rib pain and dryness of the hand, the face and the neck. Some patient also experiences a decrease in their heart rate. Other rare complications of the surgery include damage to the lung and Horner’s syndrome. However with the new ESB technique these complications are very rare.

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