Anthony J. Varro, Contributing Editor


The Optimized Treatment Protocol (OTP) for the miraDry procedure by Miramar Labs (Santa Clara, Calif.) provides a solution to undesired perspiration that is so comfortable and efficient that patients not only give it rave reviews, but often refer friends and family. The OTP utilizes a high volume of anesthesia (e.g. tumescent) coupled with high energy delivery.


As Cynthia Diehl, M.D., a plastic surgeon based in Raleigh, N.C., said, “miraDry is my favorite machine. I'm so glad I bought it. Initially I hesitated because I’d heard that the numbing injections were very painful, but this has since been resolved with the OTP.”


According to Rosalyn George, M.D., a dermatologist in Wilmington, N.C., the response after implementing OTP in her practice has been completely different. “The procedure is more comfortable, and there’s much less post-operative discomfort, numbness and tingling.”


“For safety, the tumescent anesthesia pushes critical structures farther away from where you’re delivering the heat energy,” Dr. Diehl explained. This provides the dual benefit of additional safety and patient comfort.


Sheila Nazarian, M.D., a plastic surgeon in Beverly Hills, Calif. added, “The tumescent fluid is much less painful than lidocaine,” which reportedly burns when injected.


In Dr. Diehl’s experience, when using tumescent anesthesia, “patients are completely comfortable, allowing us to treat at the highest energy level throughout the entire axillary region,” rather than dialing down for sensitive areas. “Being able to treat at the highest energy level top-to-bottom provides a more dramatic result,” she added.


Dr. Nazarian described post treatment as, “feeling like a sunburn for a day. Patients typically experience swelling for a day or two,” she added, as well as painless lumps, bumps and numbness that may last around three weeks.


Dr. George, who personally underwent both the old and new protocols, said the former caused bruising that lasted four weeks, versus one week with the OTP.


The original miraDry protocol usually required two treatments for optimum results. However, with the OTP, Dr. Diehl pointed out that no patient has requested a second treatment. Similarly, Dr. Nazarian reported that 90% to 95% of her patients require only one treatment, which patients find more cost-effective. In Dr. George’s experience, only patients with true hyperhidrosis require two treatments.


As stated by all three physicians, the vast majority of patients achieve at least 90% sweat reduction. “I haven't had to use deodorant since my treatment in August 2015,” said Dr. George.


“All of our patients are very satisfied with the procedure,” Dr. Nazarian emphasized. “Its reliability and effectiveness help people gain trust in the practice,” which results in interest in other procedures and word-of-mouth referrals.


“This is a procedure that everybody’s happy with,” Dr. George noted. Changing the protocol and marketing to all patients – those who may simply dislike odor, sweat and aluminum-based deodorants – has greatly increased the number of patients choosing miraDry, she observed.


“For many people this is a life-changer,” said Dr. Diehl. “My patients are incredibly happy. What more can I want than for people to leave my office with a home run?”


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