4 months post op Arm Reduction, I have a sharp pain. Is this normal? (photo)

Question

I am 4 months post from my arm reduction. The scar line and surrounding tissue has been numb until about two weeks ago. Now I have sharp pain and tingals in my upper under arm. Is this normal? Are the nerves just waking?

J. Timothy Katzen, MD, FACS · Answer

Hello jkwpdx, thank you
for your question. Yes, your clinical course sounds “normal”. Initially after a
brachioplasty  or arm lift, as the
swelling goes down, the nerves awaken. This can be experienced as burning,
tingling, or even burning  pain. If the
tingling or pain is excessive, please consult your board certified plastic
surgeon.

Sincerely,

J.
Timothy Katzen, M.D.

Jason M. Petrungaro, MD, FACS · Answer

You ask a great question.  What you are describing is likely the healing and reconnection of the small nerves that give your arm skin sensation.  Any surgery requiring incisions and/or removal of skin will injure these cutaneous nerves, which are so small they are not visible during surgery.  During the healing process these nerves will "talk" to each other and reconnect.  Initially you will experience numbness, which is what you describe.  Then you will start to itch and often times feel tingling and even mild sharp pains along the scar and in the surrounding skin.  This pain will typically move along the scar, and may be in one spot one day and another spot another day.  If you are having debilitating pain or pain that stays in one place and is aggravated by light touch, there may be scar tissue that has formed around a nerve, and this is called a neuroma.  These are not very common, and they can be treated with excision if it does occur.  You should be safe and check in with your surgeon if you are concerned.  Best of luck!

Lily Lee, MD · Answer

yes, it sounds like the tingling and stabbing pain are just the nerve endings finding each other again. During an armlift, the superficial nerves to the skin are necessarily cut and some injured. This is generally a good sign, especially if the pain moves around. If it sticks around for a while in the same place, I would worry about a neuroma (nerve scar ball). Your surgeon should have ways to address this if it comes to that months from now. Your doctor can prescribe medication that can reduce the pain if you are finding it unbearable.

Lisa Lynn Sowder, MD (retired) - Account Suspended · Answer

Sound to me like you are having re-innervation pain.  This can present in many ways - sharp pain, pins and needles, electrical jolts, even a feeling like someone is dripping warm oil on the area (according to one of my patients!).   Make sure you stay in touch with your surgeon.  You may benefit from some scar massage or taping or silicone gel sheeting.  Upper arm scars take a long time to "settle down", sometimes up to two years.

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