Hyperhidrosis and Osmidrosis Surgery Cost Calculator
This calculator estimates the real out-of-pocket cost of surgery and procedures for hyperhidrosis (excessive sweating of the hands, armpits, or face) and osmidrosis (axillary body odor, also called bromhidrosis) in Korea. It keeps the same pure calculation model as the Korean page for five options: thoracoscopic endoscopic sympathectomy (ETS) for hyperhidrosis, botulinum toxin (botox) injections, sweat-gland (apocrine) excision by the manual subcutaneous method for osmidrosis, ultrasonic or suction removal, and a combined excision-plus-suction technique. It reflects benefit versus non-benefit billing, private indemnity reimbursement, the out-of-pocket ceiling, and the medical expense tax credit, all on 2026 Korean rules.
What matters most: treatment purpose versus cosmetic purpose
The single biggest driver of cost is not the surgical method but the purpose. Surgery to treat primary hyperhidrosis or severe osmidrosis that disrupts daily life can qualify for Korean National Health Insurance (NHIS) benefit coverage, and it is then eligible for private indemnity reimbursement and the medical expense tax credit. Surgery done for a cosmetic (aesthetic) purpose is fully non-covered, is excluded from private indemnity by policy, and is excluded from the tax credit.
Korea Income Tax Act Enforcement Decree Article 118-5, paragraph 2 states that the medical expenses in paragraph 1 do not include the cost of cosmetic or plastic surgery, nor the cost of health-promoting medicines. So a cosmetic hyperhidrosis or osmidrosis operation, however expensive, cannot receive the year-end medical expense tax credit, and private indemnity likewise treats non-therapeutic cosmetic care as an exclusion. The diagnosis and medical record must support a treatment purpose for coverage, indemnity, and the credit to apply.
- Treatment purpose: benefit coverage possible, indemnity possible, tax credit possible.
- Cosmetic purpose: fully non-covered, no indemnity, no tax credit.
- Legal basis for the cosmetic tax exclusion: Enforcement Decree Article 118-5(2).
Procedure types and typical costs
Thoracoscopic endoscopic sympathectomy (ETS) is the definitive treatment for primary hyperhidrosis of the palms, armpits, or face: under general anesthesia a 3-5 mm incision admits a thoracoscope that cuts or clips the sympathetic nerve chain. It takes about 30 minutes, allows same-day or one-night discharge, and works immediately. As treatment it is covered, so the inpatient self-pay is 20 percent of the covered total. Its hallmark complication is compensatory hyperhidrosis (sweating shifts to the back, abdomen, or legs), it is hard to predict, and the cut nerve does not recover.
Botox injection blocks acetylcholine at the sweat glands and is non-surgical, but the effect lasts only 4-6 months, so it must be repeated and is mostly non-covered. For osmidrosis, manual subcutaneous excision removes the odor-causing apocrine glands directly and has the lowest recurrence, usually with 2-3 inpatient days; ultrasonic or suction removal uses a 1 cm incision, is same-day, leaves a smaller scar, but recurs more often because gland removal is incomplete; the combined method costs the most and is usually non-covered.
- ETS (hyperhidrosis): covered total about KRW 2,000,000 as treatment, 20 percent inpatient self-pay.
- Botox: about KRW 350,000 per session for both armpits, repeated 2-3 times a year, non-covered.
- Osmidrosis excision (manual): covered total about KRW 1,800,000 as treatment; cosmetic quote around KRW 2,800,000.
- Ultrasonic/suction or combined: usually non-covered, roughly KRW 2,300,000 to KRW 3,200,000 for both sides.
- Unilateral (one side) is charged at about 60 percent of the bilateral price because of fixed costs.
Private indemnity, the out-of-pocket ceiling, and the tax credit
For a treatment-purpose case, private indemnity reimburses the covered self-pay minus the generation deductible (for example 20 percent for a 4th-generation policy on covered items) and reimburses statutory non-covered surgery cost minus the non-covered deductible (for example 30 percent). A cosmetic case is an indemnity exclusion regardless of policy generation, so reimbursement is zero. The out-of-pocket ceiling refunds covered self-pay above the annual income-tier cap (about KRW 900,000 to KRW 8,430,000 in 2026), but these procedures rarely exceed the cap, and non-covered surgery cost is never subject to the ceiling.
The Korean medical expense tax credit (Income Tax Act Article 59-4) refunds 15 percent of medical expense above 3 percent of total salary, on the self-pay that remains after indemnity, up to a KRW 7,000,000 general cap (no cap for the taxpayer, seniors, the disabled, or the seriously ill). Amounts reimbursed by private indemnity are excluded, so only the true out-of-pocket portion counts. Because Article 118-5(2) excludes cosmetic surgery, only a treatment-purpose operation earns the tax credit; a family member who paid the bill may claim it if the patient has no income.
Botox repetition versus one-time surgery (hyperhidrosis)
Because botox wears off in 4-6 months, its cost accumulates every year, while ETS is a one-time expense. The calculator shows a break-even: how many years of repeated botox it takes to exceed the one-time ETS self-pay, using the current purpose. When ETS is covered as treatment, the one-time self-pay is low, so surgery becomes economical quickly; when done cosmetically, ETS is a full non-covered quote and the break-even shifts out several years. This lets a patient weigh a reversible, non-surgical option against a permanent operation on total cost, not just the sticker price of one visit.
How to read the result
Choose the procedure type and purpose, the treated side (bilateral or unilateral), the covered total or non-covered quote, inpatient days, anesthesia type, and for botox the sessions per year. Then set hospital level, upper-grade room and other non-covered items, the private indemnity generation, income decile, and salary. The result shows covered and non-covered self-pay, the treatment-versus-cosmetic comparison, the botox-versus-surgery break-even for hyperhidrosis, the ceiling refund on covered items, the indemnity estimate, and the final cost after indemnity and the tax credit; for botox it also shows annual and three-year totals.
This is a cost-planning estimate based on 2026 Korean rules, not medical advice. There is no single public price list for these operations, so procedure, quote, and total figures are defensible market-estimate ranges that vary with hospital, method, anesthesia, and length of stay. Coverage of severe osmidrosis and of suction methods depends on the diagnosis, so confirm benefit eligibility, indemnity, and the quote with the treating physician, the NHIS, and the insurer.
This calculator is based on Korean rules (2026 National Health Insurance benefit and non-benefit billing, the annual out-of-pocket ceiling, Income Tax Act Article 59-4 medical expense tax credit, and the cosmetic surgery exclusion in Enforcement Decree Article 118-5 paragraph 2). Figures are planning estimates, not medical advice, an insurer decision, or a hospital quote.