Your Last Alternative
If you still sweat excessively and you have given every alternative a chance ( and I mean a really good shot at it! ), only then should you contemplate surgery. Experts (for example, the Canadian Hyperhidrosis Advisory Committee) in the field will also tell you that surgery is your last ditch effort.
If you are at that point, make sure you fully understand the procedure and its possible consequences. If your surgeon does not encourage you to try all alternatives before subjecting you to surgery, then beware! One of the more frequent complications resulting from surgery is compensatory sweating. As the name implies, the body tries to 'make up' for the sweating that has been arrested by the surgery. It does so by shifting the arrested sweating region to another location of the body. A recent study* reveals that of the 1731 patients that underwent surgery (between 1995 and 2008) for axillary, palmar or craniofacial hyperhidrosis, 88.4% developed compensatory sweating. More than one quarter of the patients reported severe compensatory hyperhidrosis. About one fifth of the individuals developed gustatory sweating. So, surgery may be a viable option for those with a condition that does not respond to anything......just make sure you are aware its possible limitations.
* In press: Ann Vasc Surg Feb 2013 de Andrade Filho LO et. al. DOI 10.1016 j/avsj. 2012.05.026