Painful Complications After Cosmetic Surgery: Management of Peripheral Nerve Injury

Abstract

Background

Aesthetic procedures are among the most common surgeries performed by plastic surgeons. The prevalence of persistent pain remains unknown and underappreciated in the plastic surgery literature.

Objectives

The purpose of this article was to increase awareness of this problem while describing the diagnostic and management strategies for patients with postoperative pain after aesthetic plastic surgery.

Methods

A literature review of was performed using the PubMed database to identify painful complications of: brachioplasty, blepharoplasty, rhytidectomy, abdominoplasty, breast augmentation, mastopexy, and breast reduction. A treatment algorithm was described to guide plastic surgeons presented with patients reporting pain after aesthetic surgery.

Results

Title and abstract review followed by application of inclusion and exclusion criteria finally resulted in a total of 20 clinical studies that were included in this review. These included: lateral femoral cutaneous nerve, iliohypogastric nerve, and intercostal nerves after Abdominoplasty; median antebrachial cutaneous nerve after brachioplasty; supraorbital, supratrochlear and infratrochlear nerves after blepharoplasty; greater auricular nerve, auriculotemporal nerve, and zygomaticofacial nerve after rhytidectomy; intercostobrachial nerve after breast surgery.

Conclusions

Neuromas can be the source of pain following aesthetic surgery. The same clinical and diagnostic approach used for upper and lower extremity neuroma pain can be used in patients with persistent pain after aesthetic surgery.