Nerve Damage After Plastic Surgery

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Although rare, nerve damage is a serious complication that anyone considering plastic surgery must be aware of. Any time an incision is made in the skin, there is a possibility the nerves will be affected.

Minor nerve injuries usually heal on their own over time and become barely discernible. However, severe nerve damage that occurs after plastic surgery, can be catastrophic.

While surgical nerve injury isn't always avoidable, it's especially devastating in plastic surgery because the procedures are elective as opposed to medically necessary. This article discusses the types of nerve damage that can occur with plastic surgery, as well as treatment options that can help.

Young woman lying on operating table during facial plastic surgery
 Image Source / Getty Images

Causes and Effects of Nerve Damage

Nerve damage can occur with any plastic surgery procedure. Injury occurs if the nerves are stretched, cut, or cauterized. Damage from injections is also possible.

It may be normal to experience some pain or abnormal sensations in the skin for a period of time after surgery. However, symptoms that persist over three months may indicate a nerve injury.

Nerve damage may present with a spectrum of sensory symptoms, including:

  • Numbness
  • Tingling
  • Burning or shooting pain
  • Hypersensitivity

Certain types of nerve damage may also result in motor nerve deficits, including:

  • Weakness
  • Paralysis of certain muscles

If a nerve is severely damaged, the effects may be permanent.

Complication Rates

Any type of surgery can result in nerve damage. However, the risk of nerve injury often depends on the type of surgical procedure being performed.

One 2023 review published in Frontiers in Neurology reported the following rates of nerve complications after plastic surgery:

  • Blepharoplasty (eyelid surgery): Supraorbital nerve or supratrochlear nerve (4.0%), infraorbital nerve (2.8%)
  • Rhinoplasty (nose surgery): Olfactory dysfunction (31.8%)
  • Rhytidectomy (face-lift): Facial nerve injury (1.0%), permanent nerve injury (0.03%)
  • Breast surgery: Intercostal cutaneous nerve (8.86-10.01%), long thoracic nerve (0.01%), permanent nerve injury (1.66%)
  • Abdominoplasty ("tummy tuck"): Lateral femoral cutaneous nerve (1.36%), iliohypogastric nerve (0.1%), permanent nerve injury (1.02%)

Even when your surgeon provides the "standard of care," nerve injuries can occur.

Recovery From Nerve Damage

Most nerve damage will recover spontaneously (without treatment) within six months to a year. In some cases, it can take two to three years for complete recovery.

As the nerve heals, you may experience itching, shooting pains, or electrical shock sensations. However, these symptoms are usually temporary and are often a sign that the nerves are regaining their normal function.

That said, the following are treatment options that may help your recovery from nerve damage.

Conservative Management

Conservative treatment options include:

  • Watchful waiting: If nerve damage is suspected, watchful waiting is typically recommended to see if the nerve has the ability to heal on its own.
  • Oral medication: Pain relievers, tricyclic antidepressants, and anti-seizure medications may be used to help relieve pain caused by injured nerves.
  • Nerve blocks: This procedure involves the injection of numbing medication near specific nerves to help block pain from certain parts of the body.
  • Steroid therapy: Injections of corticosteroids may be used to help relieve pain.

Surgical Treatment

If a nerve is severely damaged, it may not have the ability to heal on its own. For example, if the nerve is severed, then numbness and the inability to move the affected muscle are permanent. Surgical intervention is required to restore function in such cases.

Operative treatment options include:

  • Direct nerve repair: This procedure involves sewing or gluing nerve ends together. This is often done when a nerve is cut sharply in half.
  • Nerve grafting: A nerve graft (nerve tissue from another part of the body) is used to fill the gap between the ends of a damaged nerve.
  • Nerve transfer: This surgery involves connecting the ends of a damaged nerve using a healthy donor nerve from another part of the body.

Nerve Damage by Procedure

Specific procedures have certain outcomes if a nerve is damaged. The tables below summarize which nerve injuries are associated with some plastic surgery procedures.

FACIAL ENHANCEMENT
Procedure Effect of Nerve Damage
Forehead/brow lift Loss of motion or weakness of forehead muscles Loss of feeling of eyelid skin, forehead, and scalp Inability to close eyes
Rhinoplasty (nose job) Numbness of nasal skin
Rhytidectomy (facelift) Facial numbness Inability to move face and make facial expressions (e.g., smiling) Drooping of the cheek, mouth, or lips Numbness of portions of the ear
Genioplasty (chin augmentation) Numbness, pain, and tingling of lips, chin, and cheeks Lower lip drooping
Neck lift Numbness of portions of the ear Drooping of the mouth or lips Neck skin numbness
BREAST SURGERY

Procedure

Effect of Nerve Damage

Breast augmentation

Increased or decreased nipple sensation
Numbness near incision
Numbness of breast skin

Mastopexy (breast lift)

Loss of nipple sensation
Numbness near incisions
Numbness of breast skin

Breast reduction

Loss of nipple sensation
Numbness near incisions
Numbness of breast skin
BODY CONTOURING

Procedure

Effect of Nerve Damage

Tummy tuck

Numbness and tingling of abdominal skin

Liposuction

Numbness at incision sites
Numbness and tingling in liposuctioned areas
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Chen Q, Li P, Zhao Q, Tu T, Lu H, Zhang W. Occurrence and treatment of peripheral nerve injuries after cosmetic surgeriesFront Neurol. 2023;14:1258759. doi:10.3389/fneur.2023.1258759

  2. Borsook D, Kussman BD, George E, Becerra LR, Burke DW. Surgically induced neuropathic pain: understanding the perioperative process. Ann Surg. 2013;257(3):403-12. doi:10.1097/SLA.0b013e3182701a7b

  3. Desai K, Warade A, Jha A, Pattankar S. Injection-related iatrogenic peripheral nerves injuries: Surgical experience of 354 operated casesNeurol India. 2019;67(7):82. doi:10.4103/0028-3886.250703

  4. Chen Q, Li P, Zhao Q, Tu T, Lu H, Zhang W. Occurrence and treatment of peripheral nerve injuries after cosmetic surgeriesFront Neurol. 2023;14:1258759. doi:10.3389/fneur.2023.1258759

  5. Penn Medicine. Nerve conditions.

  6. Chen Q, Li P, Zhao Q, Tu T, Lu H, Zhang W. Occurrence and treatment of peripheral nerve injuries after cosmetic surgeriesFront Neurol. 2023;14:1258759. doi:10.3389/fneur.2023.1258759

  7. Grinsell D, Keating CP. Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies. Biomed Res Int. 2014;2014:698256. doi:10.1155/2014/698256

  8. Midha R, Grochmal J. Surgery for nerve injury: current and future perspectives: JNSPG 75th Anniversary Invited Review ArticleJournal of Neurosurgery. 2019;130(3):675-685. doi:10.3171/2018.11.JNS181520

  9. Johns Hopkins Medicine. Nerve blocks.

  10. Johns Hopkins Medicine. Surgical repair of a nerve.

Additional Reading
  • Ghavami, A. Genioplasty. In Janis JE, ed: Essentials of Plastic Surgery. 2nd ed. Boca Raton, FL: CRC Press; 2014.
  • Loftus JM. The Smart Woman's Guide to Plastic Surgery. New York, NY: McGraw-Hill Education; 2008.
  • Siemionow MZ, Eisenmann-Klein M. Plastic and Reconstructive Surgery. London: Springer-Verlag, 2010.
  • Thorne CHM, et al. Grabb and Smith's Plastic Surgery. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins (LWW); 2013.