title: Intercostal neuroma as a source of pain after aesthetic and reconstructive breast implant surgery.
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.
authors.affiliation: 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.
authors.forename: John T
authors.initials: JT
authors.lastname: Nguyen
authors.forename: Ian A
authors.initials: IA
authors.lastname: Buchanan
authors.forename: Priti P
authors.initials: PP
authors.lastname: Patel
authors.forename: Nika
authors.initials: N
authors.lastname: Aljinovic
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
mesh_terms: D018427:Breast Implants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007366:Intercostal Muscles / Q000294:innervation; D016462:Mammaplasty / Q000009:adverse effects*; D008875:Middle Aged; D009463:Neuroma / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D012494:Sampling Studies