Burning Pain on Incision After Tummy Tuck

Hello Newdel, thank you for your question regarding the burning pain on your incision after your tummy tuck.

Experiencing searing, burning pain at your incision site nine months post-op can be concerning, especially when the pain worsens with standing and lessens when sitting or lying down. Given your surgeon’s evaluation that everything looks and feels fine, and considering their suggestion of possibly tearing a stitch or two, it’s essential to explore a few possibilities.

One potential cause for your pain could be nerve irritation or damage. Although your surgeon mentioned that nerve regeneration pain would typically start sooner, it is not impossible for nerve-related pain to manifest later in the healing process. This type of pain can occur when nerves that were cut during surgery start to heal and regenerate, leading to sensations of burning, searing, or even stabbing pain.

Another possibility is the formation of scar tissue, or adhesions, which can sometimes cause discomfort and pain, particularly when moving or standing. Scar tissue can pull on surrounding tissues and nerves, leading to the symptoms you’re describing.

Additionally, a torn stitch or internal sutures can cause localized pain and irritation. The sutures used in muscle repair or tightening can sometimes become irritated or cause inflammation long after surgery.

To manage your pain and address these issues, consider the following steps:

Follow Up with Your Surgeon: Ensure that you have a thorough examination to rule out any complications or need for additional interventions.
Pain Management: Over-the-counter pain medications or prescribed pain relievers may help manage your symptoms.
Scar Tissue Therapy: Massage therapy, silicone sheets, or laser treatments can help soften scar tissue and alleviate discomfort.
Physical Therapy: Gentle exercises and stretches prescribed by a physical therapist can improve mobility and reduce pain associated with scar tissue or nerve irritation.
Nerve Pain Treatment: If nerve pain is suspected, medications such as gabapentin or nerve blocks might be beneficial.
Given the persistence of your symptoms, it is crucial to seek a second opinion if your current surgeon cannot provide a satisfactory explanation or solution. Consulting with a board-certified plastic surgeon experienced in post-operative complications might offer additional insights and treatment options.

Good luck, and I hope this helps provide some clarity and direction for your concerns.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Patients who undergo a tummy tuck will often have twinges of pain that is related to the nerves under the skin for up to one year after the surgery. Patients who have the underlying muscle tightened could develop muscle spasms or even a tear of the tissue with exertion but this is usually within the first several months after surgery. I recommend that a physician examine you to help determine the cause of your pain.

First I recommend you do a sit up and make sure there's no pseudoherniation. You would see a bulge in the midline. This can cause pain. But scars can take up to 2 years to fully mature. Scar tissue is constantly going through a rebuilding mode until it has fully replaced the initial scar tissue with final collagen. Give it time but you may need some Lyrica to get through until it calms down.