Brachioplasty About 2 Months Ago and It Still Hurts. Why?

Question

I had a brachioplasty done a little over 2 months ago and it still hurts. Some days are worse than others. My arms still feel sore, I have shooting pain at times, and it sometimes feels like little pins sticking me. I saw the doctor about this. He said I should not be in pain still and there is nothing he can do. Is there anything that can be done or anything I can take to releave the pain? Also, since the doctor said I should not be in any pain still, I'm wondering why it still hurts.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding why your arms still hurt two months after your brachioplasty. This can sometimes happen. I believe that you're experiencing pain because of swelling. When you have to swell in the arm, the anatomic structure most commonly affected is the nerve. This can lead to localized pain in the arm or even numbness and tingling in the forearm or the hand. If severe, it can lead to numbness and even weakness in the hand. Since swelling is probably the issue, I would suggest compression. I would wear your compression garment for at least another one to two more months. I would also suggest a massage. This can be done professionally. I would suggest professional massages twice a week for six weeks. You may also need a lymphatic massage to decrease the swelling. If the swelling does not go down, you may need a nerve conduction test or EMG. This will determine where the nerve is pinched. The nerve can be pinched in your neck, shoulder, elbow, or wrist. Depending on where the nerve is compressed will dictate what needs to be done. You may need steroid pills, steroid injections, or even injections of PRP; all these can help with isolated nerve pain after a brachioplasty. I hope this helps answer your pain question two months after a brachioplasty. 
I specialize in arm lifts.  I hope that I have answered your questions regarding the arm reduction.  If you have any more questions regarding the arm lift, arm reduction, brachioplasty or arm crease fat grafting, please contact my office.  Since a brachioplasty or arm lift surgery is a difficult procedure, please seek an experienced, board certified plastic surgeon with significant experience performing these types of arm lifts. Do your research.  Make sure your chosen plastic surgeon has performed at least 100 arm lifts.  Make sure they have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Richard J. Bruneteau, MD · Answer

Patients who undergo brachioplasty often complain of pain, swelling and skin hypersensitivity. These are normal findings immediately following surgery and usually resolve with time.The pins and needles sensation that you describe is known as a dyesthesia. It's very similar to what happens when your leg falls asleep. This phenomena occurs when nerves are compressed and stretched. In many cases, this is made worse by swelling.Patients typically describe a tingling sensation which they describe as burning. In many cases, clothing rubbing against the area can elicit a pins and needles sensation.Shooting pains can occur for a variety of reasons in the immediate post-operative period. The most likely causes include nerve regeneration and nerve fibers caught within scar tissue.These symptoms usually resolve in about six to eight weeks without intervention. In some cases, aggressive massage can desensitize the area and minimize the pain and discomfort associated with this condition.

Siamak Agha, MD, PhD, FACS · Answer

It is very difficult to decipher the reasons you may still be experiencing pain as there could be a multitude of reasons. I highly suggest you contacting your operating surgeon to discuss your concerns as soon as possible.

	Sometimes it can be a nerve damage concern, or it can just be that your body heals at different rates from other patients. Please inform your surgeon immediately.

Tom J. Pousti, MD · Answer

Thank you for the question.

	It is very difficult to know exactly what may be going on with your discomfort level after surgery without examining you. However, the patient's pain threshold is different and  at the 2 months post op.  a  few patients  still complain of discomfort. Careful examination may  pinpoint a specific nerve  impingement or neuroma.

	I would suggest continued follow-up with your plastic surgeon. Pay careful attention to the level of discomfort associated with certain activities etc. If this does not resolve with time a referral to a pain specialist (to rule out unusual causes of persistent pain after surgery)  may be indicated.

	Best wishes.

Shaun Parson, MD · Answer

Thanks for your question.  It is very normal to have temporary pain or numbness following brachioplasty surgery.  Nerves can be divided into two main groups: motor nerves and sensory nerves.  Motor nerves help us to move muscles and sensory nerves help us to feel things.  Sensory nerves can be further divided into different types as well.  Some help us feel pain, some help us feel vibration or pressure.  The small nerves that help us feel pain are very small and often can take many months to fully recover after this type of surgery.  The tiny "pin pricks" are a sign that the nerves are "waking up".  If you are, or have been a smoker, or if you have prior circulation problems it can take longer for the nerves to fully recover.  In some cases it can take up to two years for the nerves to fully recover.  Give things time.  Manage your current discomfort with tylenol or anti-inflamitories as long as you are medically able to take these meds.

	Hope that helps.

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