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INTRODUCTIONPrimary hyperhidrosis (PH) is a condition characterized by excessive sweating that is inconsistent with thermoregulation needs. It has a large impact on patients' quality of life and affects their personal and professional relationships. 1,2 In the majority of cases, PH manifests in childhood and adolescence and persists throughout life. The typical clinical presentation is limited to the palms of the hands, the plantar region of the foot and/or the axilla, and it is symmetrical. It can also affect the head and face and often occurs in two or more regions of the body. The pathophysiology of PH is not fully understood, but it is known to result from stimulation of the sympathetic nervous system in its regulatory center. PH affects approximately 2.8% of the population, and there is a positive family history in 12.5% to 56.5% of the patients. 3 Patients generally seek medical care later in life, and more frequently at a more financially secure age. Thus, young people end up suffering for many years before being able to receive the current well-known medical treatment. 4,5 The initial treatment for patients with PH, until 2010, was sympathectomy. Thereafter, we began to use oxybutynin chloride as the first-line treatment. In patients for whom no adequate response to medication is attained, video-assisted thoracoscopic sympathectomy (VATS) becomes the treatment of choice.VATS is considered to be the gold standard for the definitive treatment of hyperhidrosis. It provides excellent clinical results (reduced sweating at specific sites) and leads to a significant improvement in quality of life. These positive results are, among other causes, based on factors that are known to influence the effectiveness of sympathectomy among patients with hyperhidrosis, 1 such as body mass index, resection level, 6,7 preoperative quality of life 8 and the number of resected ganglia. 9