4 weeks post op Breast Augmentation tingling driving me insane!

I started having nerve pain at around 10 days. My PS has examined me 3 times since my surgery, the last time at 2 weeks and said everything looks great, it's just nerve regeneration. Gave me some More pain medication and told me to be patient. I am exactly 4 weeks post op today, and no more pain meds, but the tingling is driving me crazy and OTC pain meds helps some, but it's still driving me insane. Is there anyone else who has prescribed something different for nerve pain??

Doctor Answers 9

Tingling and nerve pain at 1 month post-op can happen, but they usually resolve

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These things are quite common, actually, and they may involve either the skin of the breasts, the nipples/areolae, or both.  The good news is that in the vast majority of cases, these things resolve with time as the tissues heal; the bad news is that it is uncomfortable until that happens.  The things that I have found to help are the things that I learned from doing microsurgery on nerves too.  In many instances, when people have injuries to the nerves of the hands and fingers, they can become very hypersensitive as things recover.  Often we use "desensitization" therapy to help things along.  It seems counterintuitive at first, but in reality it works.  The tendency is to avoid touching the hypersensitive areas because it is uncomfortable; sometimes people even put on protective clothing or things like silicone gel pads or "pasties" to keep things from touching the affected areas.  These measures actually work against us, as the brain simply "turns up the volume" on the injured areas thinking that there  is no sensory input coming in.  The thing to do is to bombard the brain with CONTROLLED sensory input so that it becomes "retrained" for that area of the body, and it "turns down the volume" on the sensory input.  Thus, I will have my patients perform a sort of desensitization regimen themselves, and it goes like this:  they start off simply touching the affected area a couple of times a day, just laying their hand on the skin and allowing the contact and heat to stimulate the area.  Then, when they can tolerate that, I have them get a nice, pleasant smelling and feeling body butter or oil and gently and lightly rub or massage the affected skin as they tolerate, gradually working up to full rubbing, or massage of the area.  This may take several weeks, but the progressive stimulation seems to help.  Other non-pharmacologic measures that may help are cool compresses a couple times a day to the affected areas, and elevation by wearing a good bra, even while sleeping, sleeping propped up a bit, and avoiding activities that stress the breast tissues, like running or bouncing, until things get better.  I would also suggest avoiding intentionally applying heat to the area, like heating pads or even hot showers, as that will actually increase blood flow to the injured tissues, increasing swelling and thickness of the injured tissues and nerves, and possibly delay the recovery.

As an adjunct, when necessary, I'll also use some medications that are more likely to help this type of nerve pain better than simple narcotics.  In fact, there is evidence that ongoing narcotic use beyond the usual few days to a week that people need for acute surgical pain recovery can actually lead to INCREASING pain and chronic pain syndromes.  Thus, I stay away from narcotics as much as possible.  I use NSAID's, like Motrin/ibuprofen/Naprosyn/naproxen/Aleve, if you can tolerate them, as they will help not only pain, but also inflammation of the affected nerves.  Then, if we are convinced that the pain is truly of nerve origin, and we need something in addition to those medications, I may add in medications like gabapentin (Neurontin), or Elavil, in low doses, as these will also affect the pain pathways in the central nervous system.  These are all prescriptions, though, and they will need to be discussed with and prescribed by your doctor.

These are some of the things that I do in situations like this to help my patients get over the hump.  Every doctor has his or her favorite way to manage these things, though, so don't try anything without checking with your surgeon first.  And most importantly, don't get discouraged as these things almost always go away.  Good luck

San Diego Plastic Surgeon

Any surgery can cause change of sensation

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Sensation to the nipple is usually preserved with breast augmentation. The key word here is usually. Any surgery can cause change of sensation. There has been a significant amount of research into nipple sensation. The skin nerves of the breast come between the 1st to 6th ribs. The nipple-areola complex is consistently supplied by the nerve coming from the 4th rib (IVth intercostal nerve), with additional supply by branches of the 3rd and 5th intercostal nerves. This means that the threats to nipple sensation include the following:
1. Where is the incision for the augmentation placed?
2. What nerves have been injured during pocket dissection?
3. Does the size of the implant stretch the nerve?
Sometimes injuries to the nerve (especially from the third reason) will resolve over time (typically 6 months to a year) but in rare cases sensation loss can be permanent.
Be sure to discuss your concerns with an accredited plastic surgeon.

Charles Nduka, MD
London Plastic Surgeon
5.0 out of 5 stars 10 reviews

Post Op Nerve Sensations

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Thank you for your question. Typically, nerve related tingling, burning or buzzing sensations resolve shortly after the 1 month mark so you can expect this to dissipate very soon. Sometimes, once the incisions are well healed, massage of the scars and lateral sides can help desensitize the area. Your Plastic Surgeon may be able to prescribe a nerve pain medication such as Gabapentin or Lyrica if this doesn't resolve naturally for you soon.

All the best

Breast Augmentation

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Creating the pocket to place the implant disrupts nerves in this area.  Occasionally, patients can have temporary nerve pain that usually resolves by week 6-8.  If you can specifically identify the area of pain, your surgeon may consider oral anti-inflammatory medication and doing a local injection.  The implant must be positioned away from the planned injection so injury doesn't occur.  While the local is temporary it does seem to help most patients make it through these few weeks.  You may also find wearing a very supportive bra to help with your symptoms.  As the implant is settling into position the nerves can be irritated.  The support bra minimizes friction between the descending implant and the underlying nerves.  I would suggest that you follow your surgeons recommendations.

1 month post op, some advices:

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Thanks for the question.
Its too early to talk about final results.
In my practice, after performing a BA I recommend to my patients to limit the movement of the arms for two weeks. After that, you can move your arms taking care and always with common sense.
In this regard, it's not advisable to carry heavy weights to prevent the implant out of position, and allow the formation of the physiological capsule around the implant, also to avoid pain and breast swelling.
Kind regards,
Dr. Emmanuel Mallol.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 367 reviews

Hypersensitivity of Breast after augmentation

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Hypersensitivity of the nipple or breast can occur after breast augmentation and is usually more pronounced the larger the implant that is used.  The good news long term is that it almost always gets better.  I agree with Dr Grzeskiewicz very thorough answer below.  Desensitization exercises as he described can help these can be as simple as gentle massage of the breast.  In severe cases neurontin or elavil can be used.  Best of luck

Raymond Jean MD Board Certified Plastic Surgeon   Bryn Mawr Philadelphia PA

Raymond Jean, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 48 reviews

Breast Tingling Post Op

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Breast tingling or soreness is very normal after your breast augmentation. It is the result of the breast tissue being stretched.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Post-Operative Nerve Pain

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What you are experiencing is very common and should resolve over the next 2 months.  This tingling represents nerve regeneration and is a normal  part of healing.  If it is truly "driving you crazy", Gabapentin is a medication that may help these symptoms.

Eric P. Bachelor, MD
Pleasanton Plastic Surgeon
4.4 out of 5 stars 19 reviews

Tingling and nerve pain

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Sometimes tingling is a good sign as can itching be a sign of regenerating nerves. Depending on the areas that may have been numb and the incision you had, this could be sensation trying to come back. Sometimes ice packs can help and a supportive bra can also reduce some of the stretch on the regenerating nerves. Best, MMT

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.