Intercostal neuroma as a source of pain after aesthetic and reconstructive breast implant surgery

J Plast Reconstr Aesthet Surg. 2012 Sep;65(9):1199-203. doi: 10.1016/j.bjps.2012.04.003. Epub 2012 Apr 26.

Abstract

The development of persistent post-operative pain after implant placement for aesthetic or reconstructive breast surgery can lead to significant patient morbidity. Although there are many etiologies for post-operative pain, the diagnosis of an intercostal neuroma is important as this can be treated surgically. We describe three cases of an intercostal neuroma in patients with breast implants. A Tinel's sign can be elicited along the lateral chest wall and a local anesthetic block temporarily alleviates this pain. Surgical management with identification and clipping of the intercostal neuroma and burying into the underlying muscle significantly decreases post-operative pain long term. In patients with persistent pain after breast implant placement, plastic surgeons must be aware of this treatable cause of pain.

MeSH terms

  • Breast Implants / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Intercostal Muscles / innervation
  • Mammaplasty / adverse effects*
  • Middle Aged
  • Neuroma / etiology
  • Neuroma / physiopathology
  • Neuroma / surgery*
  • Pain Measurement
  • Pain, Postoperative / etiology*
  • Pain, Postoperative / physiopathology
  • Pain, Postoperative / surgery
  • Peripheral Nervous System Neoplasms / etiology
  • Peripheral Nervous System Neoplasms / pathology
  • Peripheral Nervous System Neoplasms / surgery*
  • Reoperation / methods
  • Risk Assessment
  • Sampling Studies