Burning pain after reconstruction?

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Question from Stitch: Is it common to have a burning-like pain from the reconstructed breast? I have been told by my surgeon that I have some TRAM necrosis — is this bad? And will it resolve itself or will I need further repair? I had simple mastectomy with sentinel nodes and immediate TRAM reconstruction last year. No radiation or chemo. Thanks for your time!
Answers - Joseph Serletti It's not common to have long-term pain within the breast reconstruction. What your plastic surgeon is probably referring to is the areas of fat necrosis. These typically will not change over time. I'll ask Dr. Sabol to comment on the nerve pain following surgery.
Jennifer Sabol, M.D., F.A.C.S. I think what you describe as burning pain does seem to be originating from a nerve. In most reconstruction, when you bring up the tummy tissue the nerves are actually transsected or cut, and therefore you should get no sensation from that tissue. What you may be experiencing is some pain from the sentinel lymph node biopsy site, which are the intercostal nerves. These often supply sensation to the skin over the lateral chest wall and the upper inner arm, and when they are regenerating, patients often describe a burning or raw type of sensation to the skin in these areas, even though there's no visible damage. This can take up to two years to stabilize and to go away, so I would not lose hope that your symptoms will eventually go away. On a very rare occasion, a pain specialist (anesthesiologist) may be able to localize the source of the discomfort and help with a nerve block.  You should discuss this further with the surgeon that performed the mastectomy.

The Ask-the-Expert Online Conference called Reconstruction Updates featured Joseph Serletti, M.D. and moderator Jennifer Sabol, M.D. answering your questions about breast reconstruction.

Editor's Note: This conference took place in May 2007.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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