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Research Article| Volume 65, ISSUE 9, P1199-1203, September 2012

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

  • John T. Nguyen
    Affiliations
    Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Suite 5A, Boston, MA 02215, USA
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  • Ian A. Buchanan
    Affiliations
    Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Suite 5A, Boston, MA 02215, USA
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  • Priti P. Patel
    Affiliations
    Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Suite 5A, Boston, MA 02215, USA
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  • Nika Aljinovic
    Affiliations
    Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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  • Bernard T. Lee
    Correspondence
    Corresponding author. Tel.: +1 617 632 7835; fax: +1 617 632 7840.
    Affiliations
    Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Suite 5A, Boston, MA 02215, USA
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Published:April 30, 2012DOI:https://doi.org/10.1016/j.bjps.2012.04.003

      Summary

      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.

      Keywords

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