American Society for Peripheral Nerve

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Pain After Aesthetic Surgery
Karan Chopra, MD1; Benjamin R Slavin, BS2; Georgios Kokosis, MD1; Robin Yang, MD, DDS1; Eric Williams, MD1; A. Lee Dellon, MD, PhD3
1Johns Hopkins Hospital Department of Plastic Surgery, Baltimore, MD, 2University of Miami Miller School of Medicine, Miami, FL, 3Dellon Institute for Peripheral Nerve Surgery, Towson, MD

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

A literature review was performed using the PubMed database to identify painful complications of: Brachioplasty, Blepharoplasty, Rhytidectomy, Abdominoplasty, Breast Augmentation, Mastopexy, and Breast Reduction. Subsequently, a treatment algorithm was conceptualized and described to guide plastic surgeons presented with patients reporting pain after aesthetic surgery.

Title and abstract review followed by application of inclusion and exclusion criteria via the MeSH search algorithm of the PubMed database 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.

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.

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