Is it ok to operate on neuromas after tummy tuck?

Question

I've seen a pain specialist and had a nerve block to diagnose the pain I'm experiencing after Tummy Tuck. This doctor concluded that it was at least one or more neuromas. But he also said that reoperating would not be the route to go because 50% of the time it made the burning pain worse and it caused it to spread to a larger area. Has anyone seen this and/or reoperated for a neuroma? Thank you for your time.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your excellent question about treating neuromas after a tummy tuck.

First, I’m sorry you’re experiencing nerve pain — that can be extremely frustrating, especially after such a major surgery. Neuromas, which are painful bundles of nerve endings that can form after nerve injury, can unfortunately happen after tummy tucks, though they are relatively uncommon. They tend to develop when small sensory nerves in the skin or fat are cut during surgery and then try to regrow improperly.

Your pain specialist is correct that reoperating on neuromas is a very delicate decision. In some cases, surgical removal or revision of the neuroma can dramatically improve symptoms, especially if the neuroma is well-localized and confirmed by diagnostic blocks. However, surgery itself can sometimes lead to worsening symptoms, particularly if new nerve trauma occurs or if scar tissue forms around the new surgical site. Studies suggest that about 50% of patients experience improvement, while others may have no change or even worsening pain after neuroma surgery — so it is definitely not a guaranteed fix.

When surgery is performed, the goal is often to excise the neuroma and either bury the nerve ending into muscle or fat to protect it and prevent a new neuroma from forming. This technique is called targeted nerve implantation or nerve capping, depending on the method used. Choosing the right surgeon is crucial — you would want a plastic surgeon who is very experienced in nerve surgery or possibly even collaborate with a peripheral nerve specialist.

If your pain is significant but not debilitating, many specialists would recommend exhausting all non-surgical options first, including:

Medications like gabapentin, pregabalin, or amitriptyline

Physical therapy or desensitization therapy

Nerve blocks (like you had)

Ultrasound-guided steroid injections

Neuromodulation techniques, such as TENS therapy

Only if those methods fail, and if the neuroma is clearly localized and severely affecting your quality of life, would surgical removal usually be considered.

You’re doing the right thing by being cautious and gathering information. It is absolutely possible to operate on neuromas after tummy tuck, but it requires an extremely skilled hand and a thorough discussion about risks, benefits, and expectations.

Wishing you relief and comfort ahead — you deserve it.

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS
(Certified by the American Board of Plastic Surgery and President of the American Society of Bariatric Plastic Surgeons; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery; Member of the American Society of Plastic Surgeons, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame)

Please continue working closely with your pain specialist and consult with a board-certified plastic surgeon or peripheral nerve expert if surgery is being considered. Careful planning gives you the best chance at meaningful relief.

Otto Joseph Placik, MD · Answer

You may want to find a pain specialist who can perform chemical neurolysis or radiofrequency ablation of your neuromas.
Surgical correction may require removing the neuroma
Often times this can be diagnosed by a local block if it is truly a neuroma. It is some other condition you may find it difficult to correct.

John P. Di Saia, MD · Answer

Hello,
Neuroma surgery can be difficult as it can be hard to figure out where the neuroma and the pain originate. I agree with the anesthesia pain service route (generally pain services are run by anesthesia pain specialists). Try their ablation technologies first. Hopefully these will help relieve the problem.

Is it ok to operate on neuromas after tummy tuck?

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Is it ok to operate on neuromas after tummy tuck?

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