Numb Thigh After Tummy Tuck?

Question

Hi, I made a TT 2 days ago. Since I woke up from the surgery I noticed that the outer side of my left thigh was numb, I thought that this was due to the surgery itself and that it would pass.My thight now is not only numb but I got a burning feeling specially when I sit down which goes down to the knee. They told me that a nerve was pinched and it will take time to recover. How long will it take and what can I do to releive the burning feeling? Thanks in advance!

Lewis Albert Andres, MD · Answer

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.   The lateral femoral cutaneous nerve may have neuropraxia or less likely damage.  Followup closely with your surgeon for options.  However, it should resolve over 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!

Earl Stephenson, Jr., MD, DDS, MBA · Answer

This definitely sounds like an irritation to the lateral femoral cutaneous nerve.  This nerve gives you sensation to the outer thigh.  This irritation should resolve over time with reduction in the swelling. There are medications to help relieve "nerve" pain ( neurotin, Lyrica, etc.)  The best advice is to sit down with your PS and discuss your options after a good physical exam.

	 

	Dr. ES

Richard Baxter, MD · Answer

Pinched nerves generally recover fairly slowly, so it could be several months before it recovers. There are 2 options to consider besides waiting: one would be to surgically open the incision where the nerve is being pinched and release the stitch that is probably causing it. Another is a medication called neurontin, which is very effective for nerve pain.

Marc Pacifico, MD, FRCS(Plast) · Answer

It sounds like a particular nerve (the lateral cutaneous nerve of the thigh) is causing your symptoms. This runs fairly superficially (not deep) at the outer edge of the tummy tuck scar. 

	It may be that this is a temporary symptom, in which case it may take some months to improve. However, occasionally this nerve can be permanently damaged, leaving you with long term numbness. The exact extent of this could only be determined after about 2-years, as that is how long it takes for nerves to heal, if they are going to.

	Regarding the pain, you should speak to your plastic surgeon about this, as there may be things that can be started early to minimise this (such as amitriptilline or gabapentin, both nerve-related medications).

	As you said, it is likely that the nerve was caught in a stitch, in which case it should recover with time (many months I'm afraid). Regular massaging of the area will help, but only after 2-3 weeks post-surgery

Camille Cash, MD · Answer

From your description of your symptoms it sounds like nerve pain.  This can occur when a nerve is stretched or irritated from swelling.  It should improve as you continue to heal and swelling resolves.  There are medications that can be prescribed if it becomes bothersome.

Pablo Prichard, MD · Answer

Thank you for your post.  In a tummy tuck or abdominoplasty surgery, the tissue above the abdominal muscles is lifted off of the muscles from the lower scar to the ribs in a full tummy tuck and to the umbilicus in a mini tummy tuck.  The superficial nerves that travel through the muscle to the skin are cut in order to do this.  This is what causes the numbness afterward.  The numbness usually extends in the entire area that was lifted up.  On occasion, a superficial nerve to the thigh could be pulled causing numbness in this area as well.  Swelling happens after surgery and also tends to be in the entire area that has been lifted up and any area that has received liposuction.  Both numbness and swelling may take months to years to go away, and the last place for both to go away is the area right above the incision centrally, and sometimes right below the belly button.  It may take up to 2 years to get to baseline sensation.  sometimes, certain areas never feel totally normal, especially the area right above the incision centrally. If tingling or itchiness develop, that is a sign that the nerves are growing back. This is normally well tolerated, but occasionally, a nerve type pain medication is needed such as neurontin. Best Wishes, Pablo Prichard, MD

Raj S. Ambay, MD · Answer

While performing a tummy tuck some sensory nerves are unavoidably severed. Thus, there can potentially be some areas of numbness on your tummy. Most of this resolves over time. The timeline for recovery can be weeks to 12 months. It is highly unlikely that any nerves that are motor in nature have been severed during a tummy tuck. You should follow up with your plastic surgeon and relate your concerns to him or her.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

	The location of your numbness -on the outside of your thigh-and the tingling sensation are unusual signs of nerve injury after Tummy Tuck.

	The symptoms you describe sound like a condition called Meralgia Paresthetica which more likely is caused by positioning on the operative table.

	Nerve injuries caused by Tummy Tuck would be more likely cause numbness in the medial thigh area, lower abdomen and pubis.

	I suggest that you consult a Neurologist for evaluation-this could help you avoid an unnecessary exploratory surgery.

Numb Thigh After Tummy Tuck?

Answers (8)