miraDry® Treatment Procedure for Underarm Sweating

During the miraDry® treatment, a hand piece is applied to the skin surface that delivers timed microwave energy to the underarm area. The microwave energy heats and destroys the sweat and odor glands (apocrine and eccrine) below the skin’s surface. Once destroyed, these sweat glands do not regenerate in adults⁴, making miraDry® a long-lasting solution for the reduction of underarm sweat and odor.

Most offices performing miraDry® simply use a series of lidocaine injections to numb the underarms; this can require up to 100 lidocaine shots in each underarm. Even then the nerve block is not effective enough to be able to treat patients at the highest power; it simply would not be comfortable for the patient.

At WIFH, Founder and Medical Director Dr. Jay M. Kulkin utilizes a tumescent technique to numb the underarm area prior to the procedure. The tumescent technique creates a "cooling pillow" that provides a more effective block between the skin and the nerves.

This technique sets WIFH apart from most facilities also offering miraDry®. Using the tumescent technique, our patients only receive one lidocaine injection in each underarm; this is the location where a tiny entry point is made to infuse the numbing fluid.

Citations

4. Li H., Zhou G., Fu X., Zhang L., (2009). Antigen expression of human eccrine sweat glands. Therapeutic Options. Journal of Cutaneous Pathology. 36(3):318-324, March 2009. https://www.ncbi.nlm.nih.gov/pubmed/19032382

According to miraDry®, the procedure has been performed over 140,000 times worldwide, and has been proven to be highly safe and effective.

Following the procedure, patients will experience localized soreness and swelling in the treated area, which should dissipate within a 2-3 weeks. Some patients experience temporary, short-term changes in sensation, which may include tingling or numbness, in the skin of their underarms or upper arms, which also dissipates gradually over time².

Citations

2. Glaser D., Coleman W., Fan L., Kaminer M., Kilmer S., Nossa R., Smith S., O'Shaughnessy K., (2012). A randomized, blinded clinical evaluation of a novel microwave device for treating axillary hyperhidrosis: the dermatologic reduction in underarm perspiration study. Dermatologic Surgery. 2012 Feb;38(2):185-91. doi: 10.1111/j.1524-4725.2011.02250.x. Epub 2012 Jan 30. https://www.ncbi.nlm.nih.gov/pubmed/22289389

The Week Before the Treatment

Patients should shave their underarms 3-4 days in advance of the procedure. Sweat glands mirror the shape of the hair growth pattern, so having a few days of hair growth allows the practitioners to easily identify the location of the patient's sweat glands.

The Day of the Treatment

There are no special preparations that patients will need to navigate on the day of the procedure. Patients can eat and drink as they normally would before the treatment.

While a blanket will be provided, most patients find it more comfortable to wear a sports bra or sleeveless T-shirt during the procedure, so they remain covered but with easy access to the underarm area.

To begin the miraDry® procedure, the treatment area is cleansed and a "temporary tattoo grid” is applied to the underarm. This grid marks the precise areas where the microwave energy will be delivered during the treatment.

Patients will be given one shot of lidocaine in each underarm, and Dr. Kulkin will make a tiny puncture in the skin at the numbed injection site. Through this small opening, he will infuse or tumesce the numbing fluid under the skin to create the "cooling pillow." Once numbing is complete, the miraDry® hand piece is positioned on the temporary tattooed grid and suction is applied to secure it in place. Timed microwave energy is delivered to the area and, once complete, the suction releases and the hand-piece is moved to the next section of the grid. This process continues until the entire underarm is treated.

Pain/Discomfort

Dr. Kulkin’s tumescent technique creates a “cooling pillow”, which acts as a buffer between the skin and the nerves. This provides a more complete and even blocking of the nerves, making the procedure comfortable and pain free.

Once the numbing fluid dissipates, patients will experience tenderness and soreness of the treated area. This can be treated with Tylenol or Ibuprofen.

Treatment Duration/Frequency

Each arm pit will take approximately 30 minutes to treat, and the procedure takes approximately 2 hours from start to finish.

While results will vary from person to person, most patients report a 70%-90% reduction in sweat and odor production with one treatment. Clinical studies have concluded a reduction of sweat by 82% and odor by 89%, on average².

Some WIFH patients opt to have the treatment done a second time to achieve further reduction. However, we advise waiting 3 months following your initial procedure before considering a second. We offer second procedures at a significant discount.

Citations

2. Glaser D., Coleman W., Fan L., Kaminer M., Kilmer S., Nossa R., Smith S., O'Shaughnessy K., (2012). A randomized, blinded clinical evaluation of a novel microwave device for treating axillary hyperhidrosis: the dermatologic reduction in underarm perspiration study. Dermatologic Surgery. 2012 Feb;38(2):185-91. doi: 10.1111/j.1524-4725.2011.02250.x. Epub 2012 Jan 30. https://www.ncbi.nlm.nih.gov/pubmed/22289389

At the completion of the procedure a band-aid will be placed on the patient's incisions in each underarm. Patients will need to apply ice packs to the areas in intervals of 30 minutes (30 minutes on, 30 minutes off) for the remainder of the day to help reduce swelling. These ice packs will be provided to the patient the day of their appointment.

Most patients experience some swelling and tenderness in the treated area anywhere from 3-7 days.

Results are immediate, and patients should experience continued improvement in sweat and odor reduction the coming weeks. Final results are assumed at 3 months.

Because only 2% of the body's 4 million sweat glands are destroyed during the procedure⁵, still allowing the body to maintain proper temperature, miraDry patients do not experience compensatory sweating.

Citations

5. Taylor N., Machado-Moreira C., (2013). Regional variations in transepidermal water loss, eccrine sweat gland density, sweat secretion rates and electrolyte composition in resting and exercising humans. Extreme Physiology & Medicine. 2013; 2:4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710196/

We believe consultations are very important to help patients understand miraDry® and our unique technique. Our consultations give us the opportunity to get to know the patient and understand their individual case.

At WIFH, consultations are done with a member of our clinical team. During the consultation, the patient's medical history and underarm areas will be reviewed by the practitioner. We recommend wearing a tank top or camisole to make for easy evaluation of the underarm area. Patients will also be provided with a realistic expectation of results.

Many patients who come to WIFH have done significant research prior to their consultation, and are ready to move forward with their procedure. For this reason, we can schedule both your consultation and treatment for the same day.

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Most patients will only require one miraDry® treatment; the cost of that treatment at WIFH is $2,650. Should a patient decide to undergo a second treatment, the cost of that treatment is significantly reduced.

Click here to see WIFH’s current miraDry® pricing.