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Hyperhidrosis Overview
Hyperhidrosis Treatment Options Buffalo Niagara aand Southern Ontario for




Dr. Hratch Karamanoukian has been treating patients with hyperhidrosis since he finished his training as a cardiothoracic surgery in 1999. As such, the Center for Excessive Sweating is a National Center of Excellence for Hyperhidrosis. The Center for Excessive Sweating is only one of 2-3 centers in the United States that offer every treatment for hyperhidrosis - medical treatments, topical therapy, Botox, suction curettage, miraDry, micro ETS, sympathectomy and the STITCH procedure.


Dr. Karamanoukian, as Director of Minimally Invasive Cardiac Surgery and Robotc Surgery at Buffalo General Hospital in 1999 started using the first robotic surgery system (Zeus, Computer Motion, Inc.) to perform endoscpoic thoracic sympathectomy. With this experience, he perfected the techniques of localizing and minimizing the surgical trauma associated with traditional sympathectomy and developed the STITCH procedure (trademarked by Dr. Karamanoukian - Sympathetic Trunk Interruption with Titanium CLips). Dr. Karamanoukian has expertise in performing traditional and selective sympathectomy (T3, T4) to treat palmoplantar hyperhidrosis.


Dr. Karamanoukian also added expertise over the use to use Botox for the treatment of hyperhidrosis for the underarms, palms, feet, groin and other areas of troublesome hyperhidrosis (under breasts, chest, back, thighs). Botox is FDA approved for the treatment of hyperhidrosis of the underarms and is also used for craniofacial hyperhidrosis in our practice. These patients have debilitating hyperhidrosis with dripping sweat from the face and scalp.  Patients seek Dr. Karamanoukian from the NorthEast and have traveled from as far away as British Columbia, Canada, Saudi Arabia, California and Singapore, Japan, Egypt, Kenya, among others, for his expertise. Canadian patients in Southern Ontario routinely visit our center for evaluation and treatment and are welcome at our facility.


Map of Hyperhidrosis Patients in North America

Hyperhidrosis Patients in North America

Map of Hyperhidrosis Patients in Ontario, Canada

Hyperhidrosis Patients in Ontario, Canada



At the Center for Excessive Sweating, we also use the miraDry system to treat underarm sweating and we have performed this procedure in a large number of patients with hyperhidrosis and bromhidrosis. miraDry is FDA approved to treat hyperhidrosis and hasbeen shown to also provide relief from bromhidrosis, or excessive odor which can occur in patients with or without underarm hyperhidrosis. Dr. Karamanoukian has used his expertise with the miraDry procedure to wrtie a book about this new and emerging technology.


The miraDry Procedure for Underarm Sweating


The suction curettage procedure is very in treating underarm hyperhidrosis. Having done a lot of these procedures in the past, we now recommend the miraDry procedure as an alternative to the suction curettage procedure as it avoids incisions and is less invasive. Dr. Karamanoukian has performed the miraDry procedure in patients who have had late failure from suction curettage. Patients who have had the suction curettage procedure and want to be evaluated for the miraDry procedure can contact Dr. Karamanoukian for advice and consultation by calling 716-839-3638 or via email


Dr. Karamanoukian has written 5 books about hyperhidrosis and they are available for free for his patients. The miraDry book is shown above. Here are the other 4 books:


'The Healthy legs and Feet Guide to Hyperhidrosis' - a book about hyperhidrosis of the feet by Hratch L Karamanoukian, MD FACS and Raffy L Karamanoukian MD FACS -


The Healthy Legs and Healthy Feet Guide to Hyperhidrosis





Hratch L Karamanoukian MD FACS and Raffy L Karamanoukian MD FACS write a book about excessive underarm sweating, a condition known as hyperhidrosis.'Hyperhidrosis of the Underarms - Natural Remedies, Prescription Medication, Antiperspirants, Botox, Suction Curettage, Sympathectomy and miraDry Procedure' -




 Hyperhidrosis of the Underarms




'Hyperhidrosis Expert Series - Excessive Sweating of the Palms' is a book about hyperhidrosis written by Hratch L Karamanoukian MD FACS and Raffy Karamanoukian MD FACS.




 Excessive Sweating of the Palms








'Hyperhidrosis Expert Series - Craniofacial Hyperhidrosis - Treating Excessive Sweating of the Head and Neck' by Hratch L Karamanoukian MD FACS and Raffy L Karamanoukian MD FACS.




Craniofacial Hyperhidrosis

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