How common is it to have residual nerve pain or compartment syndrome after cosmetic procedures? (photo)

Question

Hello, I’m looking into getting a full TT with an armlift. How common is it to have residual nerve pain or compartment syndrome after either of these procedures. Someone I know lost all feeling in her right leg and arm after her TT and Armlift. I’m so nervous to proceed.

Finny George, MD · Answer

Hi, thank you for your question. 
I’m so sorry to hear about your friend’s complications. Thankfully, these are very rare and in the case of a compartment syndrome, unheard of. 
Temporary sensory changes below the belly button after TT, and medial arm after brachioplasty are possible, but less aggressive & more careful technique can avoid these also. 
If you are generally healthy, you would be a great candidate for abdominoplasty. Make sure to consult with a board certified plastic surgeon. 
I hope this helps. Best of luck!

Robert M. Wald, Jr., MD · Answer

Thank you for your question and I understand why you would be nervous to proceed with this surgery. The nerve issues that you described are very uncommon and are very unlikely following this surgery. I would you suggest you seek out a qualified and experienced surgeon and discuss these potential complications.

Daniel Barrett, MD · Answer

Dear ElleH525,
when you do the tummy tuck, you cut some of the loose skin and there is a chance that some nerves will be also cut. This can cause which is temporary in most cases and resolves with time. Compartment syndrome occurs after injuries of extremities when blood can't get out and causes increase of pressure inside compartments. Armlift removes excess skin from arms and it doesn't affect structures inside compartments so the chance of compartment syndrome is really low. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

numbness is typical in some areas after a tummy tuck but most of  the feeling comes back.  A compartment syndrome could occur on an arm lift if it is made too tight which might also explain your fruend’s Symptoms although it doesn’t sound like a true compartment syndrome.  From your photo  not sure you need the arm lift .  Very large scar that can be quite noticeable.  You need a lot of looseness to make an arm lift witthwhile.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  There may be some subtle skin sensation changes after a tummy tuck (typically in a triangle shaped pattern from the belly button down to the horizontal scar) and brachioplasty (along the scar line in the inner arm) but fortunately this is rare, while compartment syndrome is virtually unheard of.  Hope this helps.

Cameron Craven, MD, FACS · Answer

Damage to sensory nerves after tummy tuck's and arm lifts are a rare complication. With the tummy tuck there is a sensory nerve that crosses the hip and if injured can result in numbness in parts of the thigh. Fortunately this is a very rare occurrence. With the arm lifts there is a sensory nerve vulnerable above the elbow which if injured can result in numbness in the medial forearm. Additionally with arm lift procedures excessive tightness in the upper arm can result in other nerve symptoms which may be similar to compartment syndrome in some ways however is not a true compartment syndrome. Usually excessive tightness of the skin from an arm lift resolves quickly as the skin stretches. Other types of nerve pain can also occur after these surgeries such as pain in the scar or in the muscle of the abdomen from the plication. You should discuss these concerns with your surgeon so they may council you about your specific risks. Good Luck!

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Elle,
Hello and thank you for your excellent question. Long-term nerve pain like you have described is extremely uncommon after a tummy tuck or arm lift. You may want to look into a body contouring procedure that combines liposuction with laser, radiofrequency (RF), and acoustic therapy to produce the best balance of fat reduction and skin tightening and smoothing for your body type and anatomy. We use a proprietary liposuction technique, combined with Emsculpt to help each patient reach his or her desired result. First off, all devices and instruments used are FDA-approved. We start your treatment with Emsculpt to help strengthen your abdominal muscles, augment your buttocks, and reduce any diastasis or abdominal muscle laxity that you may have. This is particularly important for patients who want convert a “round” abdomen to a “flat” abdomen. Emsculpt has been proven to be able to do this based on peer-reviewed research. We then use Smart / Laser Liposuction or VASER (ultrasound) to reduce dense, fibrous fat, and stimulate collagen formation; Radiofrequency-based skin tightening to maximize skin contraction; and Ultrasound, RF, or subcision (Z Wave, Venus, Cellfina) to treat cellulite, maximize fat reduction, and smooth out any irregularities postop. These procedures are usually performed in the office, with only local anesthesia. Patients go home the same day as surgery, do not need any narcotics postop for pain control, and can return to light exercise and work two days after their procedure. In my practice, we select the appropriate treatment for each patient based on their skin quality, amount of fat and surgical goals. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. Preoperative visualization with Crisalix can simulate what your body will look like after surgery and can help you make your decision. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS

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