One thing I've discovered with my research is that there really isn't any research on these types of surgeries by independent, disinterested researchers and there is no independent oversight. When you purchase an approved medication, you can at least be assured that the the trials and research were scrutinized by an independent government agency. Research on surgical procedures receive no such oversight unless there is some device involved that a company is looking get approved.

That said, our library section has links to numerous research articles. There are many more buried in the threads here. I'd advise reading the full article in all cases rather than just the abstract. I've found the information chosen for the abstract is often cheery-picked from the results. In six years of research, I've only found one that actually measured perspiration before and after surgery. It found that patients perspired just as much or more after surgery as before. Only the location changed. That fits with what I've concluded from anecdotal information I've collected by conversing with several hundred happy and unhappy ETSers. It's really hyperhidrosis displacement surgery. Whether you are satisfied or not depends on whether you consider the displaced hyperhidrosis to be an improvement in quality of life or not.

There are objective, quantitative studies of the surgical effects on the heart, respiratory airways and peripheral ciruculation. These studies show measurable and substantial degradation in functioning of those organs and symptoms.

Since I believe you will find conclusive evidence lacking regarding T4/T5 surgery, I'm going to suggest that you consider some factors that are not addressed in any of these studies. These are factors that I am convinced are of far greater importance than the location or technique of the surgery. First, accept that bad side effects and regret have been demonstrated to occur using all different techniques and at all locations. So, there is always a risk of bad side effects regardless of technique or location. Second, understand that two individuals with identical outcomes may have a completely different take on their post-op condition due to their lifestyle and willingness to make accommodations for the side effects.

For example, someone living a sedentary life in cold or mild climate will likely consider the compensatory hyperhidrosis to be no big deal. Meanwhile, another person with the same objective outcome who is athletic, loves the outdoors and/or is living in a warm/hot environment will find the effects of the surgery horrible. Same objective result, different subjective outcome. One person's mild CS is another person's severe CS.

So, while you are trying to convince yourself that T4/T5 surgery gives you a better shot at being happy with the outcome, ask yourself these questions: Am I willing to make accomodations for trunkal hyperhidrosis such as wearing extra layers of underclothing and being selective about the colors/paterns I can wear? Am I willing to take medications to control the CH? Will a decrease heart rate affect my ability to perform the tasks of my job or reduce my athletic abilities? What is the climate where I live? Do I enjoy warm weather activities? Does my job require me to be exposed to extreme temperatures? Does my job require physical exertion?

Given you are in the Navy, I suspect you have little control over your attire. I would also suspect that being in the military means being exposed to temperature extremes and engaging in physical activities.

While I know I'm biased and I cannot offer any scientific evidence to support my position, I believe these factors are far more important than whether your sympathetic trunk in severed at the second rib or at the fourth rib.

Good luck.