Is it normal 4 weeks post op Mastopexy with Augmentation to have such burning pain?

Hello! Thank you for your question! Numbness after any surgical procedure is expected for several weeks to months following. As the nerves to the area are traumatized and will then experience a temporary neuropraxia, a transient loss of nerve conduction. This usually resolves over the next 6-12 weeks, but depending on the procedure performed, sometimes much longer. Typically this should resolve by 1 year. As it goes past this date, the likelihood of the sensation returning is small. However, it can take up to 2 years. If no return from there, it is unlikely to return. It should be discussed that persistent sensory changes may develop following any surgical procedure. There is small rate of sensation change in breast augmentation - moreso for breast lift and reduction, where the nipple is cut and moved. If this was not done during your breast augmentation, sensation should return over the next several weeks to months. The usual signs of the nerves regenerating and neuropraxia resolving is itching, followed by a burning sensation and then occasional sharp, shock-like pains. These will be normal to experience, and actually a promising sign. Usually, normal sensation returns, but is is also possible to have decreased sensation or even increased sensation to the areas affected. Re-educating nerves postoperatively is often helpful and will allow proper instruction for the affected sensory nerves - methods include using different textures to the affected areas when showering, bathing, applying lotion, etc. If bothersome, there are some medications that may be helpful, including Neurontin for pain for hypersensitivity. You can try various textures such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is also beneficial for the incision to make the finest scar possible. The last place to regain the sensation will be directly adjacent to the incision/scar as the nerves will make its way from the periphery to this location. If continual pain arises, evaluation is warranted. After ruling out other causes, one rare explanation may be that a neuroma has developed and may require surgical excision. This is very unlikely unless a large sensory nerve has been transected inadvertently during the procedure. Hope that this helps! Best wishes!

Thank you for your question.  A kind of pain that you describe, a burning pain is almost always related to stretching or pressure on the nerve that goes from about the arm pit to the nipple.  If this is the distribution of your discomfort and it is likely due to stretching of the nerve.  This usually will resolve with time.  Warm soaks may help.  The earlier you are able to do stretching exercises with your arms to stretch the muscle and the tissue the sooner you will improve.

Burning pain after a mastopexy augmentation is not unusual. It is generally caused by the sensory nerves  that innervate the skin of the breast coming alive again. As long as you have no signs of infection, are well supported  with a bra and are regularly seeing your plastic surgeon you should be fine. Sometimes a muscle spasm medication will help you with the crampy pain.