Cosmetic Surgery Tips

Nerve Pain After Tummy Tuck

Tummy tuck is a cosmetic procedure that is meant to remove excess fat and skin from the abdomen. It can also be used to improve the appearance of the lower torso, especially after pregnancy.

While there are many benefits to this procedure, it is not without risk. Nerve damage is one of the most commonly reported side effects of a tummy tuck and can occur during surgery or afterwards. This article discusses what causes nerve pain after tummy tuck and how you can manage your symptoms.

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Typically, there is a certain degree of pain or discomfort you can expect following surgery. Surgical procedures are traumatic for the human body, and pain may be attributed to your body trying to heal injured tissues. In some instances, however, nerve pain develops afterward and this isn’t the same kind of pain you should probably expect.

Woman getting prepped for a tummy tuck

As we’ve noted throughout our website, nerve pain is often marked by symptoms like burning, shooting, stabbing, and searing pain. For some patients, external stimulation—even at low levels (like wind blowing over skin or water coming down from a showerhead)—causes intense physical sensations. Others experience “pins and needles” or feel as though a specific body part or region has been plugged into an electrical outlet.

If you have those kinds of symptoms, the pain is likely caused by a nerve issue of some kind.

In some cases, these symptoms begin after procedures like C-sections (cesarean section deliveries) and tummy tucks. When they do, it’s understandable for patients to wonder why this is happening to them. So, let’s look today at why you are having nerve pain after those kinds of procedures.

To start, it is worth noting that nerve pain does not imply that anything was done incorrectly during the surgery. Surgeons, by very definition of their job, have to cut tissues to repair medical problems. Your body has an entire network of nerves running throughout, so this means there are times when nerves will also be cut during surgery. It’s just a fact.

Nerve Pain after C-section

As with other surgical procedures, it is virtually impossible to perform a C-section without cutting into some nerves. That said, long-term nerve injury after a C-section tends to be somewhat rare.

Often, nerves will heal without causing any lasting issues. When injured nerves do not heal correctly, it is considered to be nerve damage. Depending on which nerves are damaged—and their respective functions—there are various short-term and long-term symptoms that can develop. These symptoms can include impaired motor function and nerve pain.

If you have had a C-section and are experiencing a superficial pain around the edges of the scar, it is likely the ilioinguinal, iliohypogastric, and/or genitofemoral nerves have been affected. Usually, the pain presents as a burning pain and hypersensitivity – which means even light touch hurts (like in the earlier examples of wind and water). There may also be “electric shock” sensations.

If pushing on the affected area does not reproduce the pain, those specific nerves are less likely to be responsible.

The reason for noting the ilioinguinal, iliohypogastric, and genitofemoral nerves comes down to their locations. Surgeons do attempt to avoid important nerves as much as possible, but these ones run close to the edge of a C-section incision. This makes it easy for them to be injured during the procedure (bruised, crushed, etc.) or trapped in scar tissue afterward.

If you are having painful sensations, it is more likely the nerves were injured, instead of being cut. We can say this because cut nerves tend to produce numbness instead of pain. Although, there are times when both numbness and pain result from cut nerves (which is a condition called anesthesia dolorosa).

When diagnosing your nerve pain after a C-section, we use a nerve block. This is a matter of using anesthetic to cause temporary numbness for the affected nerve. When there is both numbness and pain relief, it indicates a peripheral nerve injury. If there is numbness without pain relief, something else is likely at play.

Nerve Pain after Tummy Tuck

Tummy tucks—abdominoplasties—are some of the most common cosmetic procedures performed in the United States, with the American Society of Plastic Surgeons reporting 127,633 in 2016. This is a 104% increase from the 62,713 performed in 2000.

Experts believe the number of abdominoplasties will only increase due to both the number of esthetic surgical procedures and increase in how many obese patients achieve massive weight loss following bariatric surgery.

As with other surgeries, nerves to the affected area are traumatized from a tummy tuck. This can cause numbness for several weeks to months before the nerves overcome temporary neuropraxia (loss of nerve conduction). Usually, it only takes around 6-12 weeks for the situation to resolve, but there are cases wherein this may take longer.

Whereas this numbness and a certain degree of discomfort can be expected, it can be a problem when nerve pain has developed and is not going away after a reasonable amount of time.

In the case of nerve pain following a tummy tuck, it is probably a small nerve called the lateral femoral cutaneous nerve that is affected. This particular nerve travels directly through the areas manipulated during a tummy tuck and could easily be injured directly by a suture or scalpel, or indirectly when the nerve becomes entrapped in scar tissue.

That said, it is important to note that factors other than nerve damage could be responsible for pain and sensory abnormalities. For example, massive weight loss can cause extreme skin expansion and a patient who had undergone bariatric surgery may also have had other issues (secondary fibrosis, hernia) corrected during the tummy tuck.

Diagnosis and Treatment

When you have nerve pain following surgery—particularly if the pain has been present for an extended period—you deserve to find out what is responsible. In the case of C-sections and tummy tucks, it could be inadvertent nerve damage. If so, we may be able to provide the care you need.

Managing Pain After a Tummy Tuck Surgery

Abdominoplasty, also known as a tummy tuck, is a cosmetic surgical procedure that flattens the abdomen by removing excess fat and skin and tightening the underlying muscle. Most people recover within several weeks. You may experience swelling and moderate pain during your post-operative recovery, both due to the procedure itself and because of movements you make while your incision is healing. You can get through this period more comfortably by trying several strategies for managing the pain after a tummy tuck.

A woman laying in a hospital bed

Lifestyle Management

As you are recovering from your surgery, there are practical things that you can do during the first few months to prevent pain from starting and to reduce your pain if you have any.

  • Maintain physical activity: As you recover, you should continue to carry out simple day-to-day tasks and regularly get up and walk around your home. This is recommended to reduce your risk of developing harmful blood clots, and it also prevents you from remaining in one position for too long, which can make it painful when you finally get up and move.
  • Avoid strenuous exercise: As you are recovering and your wounds are healing, you should not put a strain on your incisions by engaging in strenuous activity or lifting heavy objects for at least six weeks or until you get the green light from your healthcare provider. If you would like to begin or get back to challenging exercises once you are fully recovered, it is a good idea to maintain some level of fitness by walking for exercise throughout your recovery period.
  • Don’t smoke: To enhance the healing process, you should avoid the use of tobacco. Nicotine severely compromises the body’s ability to heal. It causes blood vessels to narrow, making the delivery of oxygen to the skin cells at the incision site more difficult, ultimately delaying the healing process.
  • Avoid constipation: You may be constipated if you are not eating due to nausea or fatigue. Narcotic pain medications also cause constipation, which eventually leads to abdominal pain. Try to eat food that is high in fiber and drink ample amounts of fluid to avoid constipation. If nausea or constipation are persistent, you may need to take over-the-counter or prescription medication.

Pain Management

Often, tummy tuck procedures include injection of pain medications into the area around the sensory nerves, resulting in a nerve block. This pre-emptive measure has been shown to reduce postoperative pain. However, if you experience postoperative pain, you may need treatment as you recover from your tummy tuck surgery. Options include:

  1. Over-the-counter medication: Many surgeons recommend taking ibuprofen or naproxen 24 to 48 hours after the procedure if there is no evidence of bleeding. NSAIDS can decrease the swelling and offer pain relief which can allow patients to stop narcotics earlier resulting in fewer side effects from those drugs.
  • Prescription medications: Long-acting narcotic pain medications are often prescribed because they do not cause bleeding. However, at low doses, narcotics can cause constipation; at high doses, they can cause breathing and heart problems, as well as addiction risk.
  • Pain pump: If you have severe nausea and cannot take medication by mouth, a pain pump—a device that delivers medication directly into the body via an inserted tube—can be another alternative. If your pain is severe, a pain pump can reduce your need for high doses of prescription narcotic pain medication.

Post-Operative Care

There are some routine things you need to take care of as you heal after your surgery, including wearing a compression garment, wound care, and drain care. Paying careful attention to these tasks can help reduce or prevent pain.

  • Compression garment: After surgery, you will be wrapped in or given a compression garment to wear. The compression garment will reduce swelling and support the abdomen, promoting proper healing. You should expect to wear this for two weeks to two months, depending on how quickly you are healing. Be sure to tell your medical team if the compression garment is causing any pain, as adjustments may be needed.
  • Incision care: Surgical dressings or bandages will be applied to your incision area. You will be given instructions about whether you should change these bandages and, if so, how often and how to do it. The most important aspect of your at-home wound care is that you keep your wound clean and remain gentle with it to avoid injury or bleeding. You will also be given instructions to be on the lookout for problems, such as pain from the incision site, swelling, redness, pus, warmth, or bleeding.
  • Drain care: After an abdominoplasty, temporary tubes to drain excess fluid from the surgical site will be inserted under your skin. They will be removed during the first week of recovery or when your healthcare provider is assured that the fluid no longer needs to be drained. If you experience pain at the drain site, or if you notice redness, swelling, or oozing of pus or blood, tell your healthcare provider’s office.
  • Antibiotics: You may be given a prescription for medication to apply to your surgical site and/or to take orally to reduce your risk of developing a postoperative infection. An infection can cause pain, but more common symptoms of infection include fever, swelling, warmth, or pus.

A Word From Verywell

A tummy tuck is generally well tolerated. However, it is a surgical procedure, and there are some risks and side effects—including pain. If you are planning to have a tummy tuck, you should be prepared for one to two months of recovery, and you may experience pain throughout this time. In general, pain is mild to moderate after a tummy tuck. Rarely, pain or sensory abnormalities can persist for months or even years after the procedure. If your pain is severe or persistent, you should tell your healthcare provider.

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