Sensitivity and Burning After Tummy Tuck

Patients who
undergo abdominoplasty often complain of pain, swelling and skin
hypersensitivity. These are normal
findings immediately following surgery, and usually resolve with time.The hypersensitivity that you
describe is known as a dysesthesia.It’s
very similar to what happens when your leg falls asleep.The phenomena occurs when the nerves are
compressed or stretched.In many cases,
this is made worse by swelling.Patients typically describe a
tingling burning sensation that can be very uncomfortable.In many cases, clothing rubbing against the
area can elicit a pins and needles sensation.These symptoms usually resolve in
about 6 to 8 weeks without intervention.In some cases, aggressive massage can desensitize the area and minimize
the pain and discomfort associated with this condition.

Thank you for reaching out with your concerns about the extreme sensitivity, burning, and shocking feelings you are experiencing 7-8 weeks post-op from your tummy tuck. It's understandable that these sensations are causing discomfort and frustration.

The symptoms you're describing are not uncommon after a tummy tuck and can be attributed to the nerves in the skin and abdominal area beginning to regenerate or reactivate. Here are several suggestions to help manage and alleviate these sensations:

Continue Wearing Compression Garments: Although you are working on weaning off the support garments, it might be beneficial to continue wearing them if they provide some relief. They can help stabilize the skin and reduce irritation caused by clothing movement.
Gentle Massage: Gentle massage can sometimes help reduce sensitivity and discomfort. Use a hypoallergenic or soothing lotion to gently massage around the scar and abdomen, which can help desensitize the area and promote circulation.
Topical Treatments: Consider using topical numbing creams or gels that contain lidocaine to numb the area temporarily. These can be particularly useful before you put on clothing or at the end of the day when discomfort can peak.
Cool Compresses: Applying cool compresses to the sensitive areas can provide temporary relief from burning sensations. Be sure not to apply ice directly to the skin—instead, wrap it in a cloth.
Medications: Since over-the-counter pain relievers are not providing sufficient relief, discuss with your surgeon or physician the possibility of prescribing stronger pain management solutions or medications specifically for nerve pain, such as gabapentin or pregabalin.
Clothing Choices: Wear loose, soft clothing made from natural fibers, which can be less irritating to sensitive skin. Avoid garments with tight elastic bands that could press on the healing tissues.
Vinegar Baths: Since you mentioned that vinegar baths help somewhat, continue using them if they provide relief. However, ensure that the water is not too hot as extreme temperatures can aggravate the sensitivity.
Consult Your Surgeon: It is crucial to keep your plastic surgeon informed about these symptoms. They might have additional recommendations based on their knowledge of your specific surgical procedure and recovery. They can assess whether your healing process is typical or if there might be other underlying issues contributing to your discomfort.
Recovery from a tummy tuck is a gradual process, and it can sometimes take several months for nerve-related symptoms to resolve fully. Please know that these sensations typically diminish over time as your body continues to heal.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

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 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!