The following data are from Eastern Surgical, part of an Australian outfit that performs ETS among other procedures. You may download the complete PDF file from which all these quotes were taken. This is not in any way an endorsement of them. Bear in mind that this comes from Doctors who promote ETS, so clearly they attempt to put the least negative spin on all of it. Still, we find it very revealing.

Death. We are aware of nine deaths worldwide from this procedure.

Lung problems. In order to get access to the sympathetic nerves in the chest it is necessary to collapse the lung. At the end of the procedure the lung must be re-expanded and all of the gas removed from the chest cavity. Sometimes the lung does not expand completely and some gas is left inside the chest cavity. This is called a pneumothorax.

Horner's syndrome. Horner's syndrome is caused by damage to the stellate ganglion. This is now very rare in the ETS operation for craniofacial sweating when the nerve is clipped at the level of the third rib, well away from the stellate ganglion. The most obvious sign of Horner's syndrome is a droopy eyelid. Less obvious is constriction of the pupil, a slight sinking of the eyeball and some redness of the white part of the eyes.

Post-operative Pain. It is common to have some vague pain in the centre of the chest following ETS. A few patients may experience pain along the inner aspect of the arm. This is usually related to trauma to the lower nerve plexus to the arm and in very rare instances may be permanent.

Nerve Damage. Damage to the nerves between the ribs (intercostal nerves) can occur occasionally. Nerve damage presents as a dull pain or numbness in the inside of the arm or along the route of the rib. In nearly all cases this is temporary and returns to normal within a few weeks or months. The cause of this is bruising to the nerves during the operation. Very rarely this may be a permanent problem.

Compensatory or Reflex Sweating. This is the most common . . .of the known side-effects of ETS surgery for severe craniofacial hyperhidrosis. ETS surgery, as well as stopping the sweating on the head and scalp, will stop nearly all sweating on the hands. For reasons that we do not fully understand, almost all patients will experience some increased sweating in other areas of the body, principally on the chest, back, groins and thighs. The increased sweating can vary from almost nothing through to an annoyance but in a small percentage of cases, less than 5% in most studies, the increased sweating may cause as much or more distress than the original craniofacial sweating problem.

IF YOU PROCEED WITH THE ETS OPERATION FOR SEVERE CRANIOFACIAL SWEATING YOU ACCEPT THE SMALL POSSIBILITY OF DEVELOPING SEVERE COMPENSATORY SWEATING WHICH MAY NOT BE ABLE TO BE REVERSED.

Gustatory Sweating. Gustatory Sweating is excessive sweating on the temporal region of the face stimulated by the smell or taste of food and drink.

Dry Hands. Your hands may be completely dry after the ETS procedure. This can sometimes cause difficulties with handling paper and may require regular use of moisturising creams or lotions.

Changes to the Heart and Circulation. Sympathectomy causes changes to the heart and circulation which are well documented. The heart rate is slowed but the heart compensates by pumping slightly more blood with each heart beat. The maximum heart rate in exercise is decreased but for most people there is no change in physical capacity. There is anecdotal evidence that very high performing athletes may suffer a small decrease in maximum physical capacity and if you are an elite athlete you should discuss this very carefully with your surgeon. Minor changes to blood pressure can occur but these tend, if of any significance at all, to be of more benefit than harm. Very rare reports have been made of recurrent episodes of fainting after ETS. Whilst probably related to the sympathectomy, the exact cause is not known.

Prickling Sensations on Scalp. Some patients notice an unpleasant prickling sensation on the scalp after eating, particularly spicy meals.

A huge variety of symptoms have been ascribed to the sympathectomy by patients, particularly those who have not had a good result or who have other side-effects of the procedure. These include symptoms such as

Loss of libido, tiredness, hair loss, funny feeling in the chest, pains in various parts of the body and many other unexpected symptoms.