Background: Abdominoplasty is a common cosmetic procedure; nerve injury is an underexplored risk of the procedure. Objective: The authors review existing literature to examine the incidence and treatment of nerve injuries after abdominoplasty procedures and provide a treatment algorithm based on their results. Methods: A search of the literature on MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews was undertaken. After full-text review, 23 articles met our criteria. Any mentions of nerve injury, including references to a lack of nerve injury, were documented. All data were pooled for analysis. From our combined data, we calculated the risks of postabdominoplasty nerve injury by dividing the total number of nerve injuries by the total number of patients. Results: Pooled data showed that 1.94% of patients sustained specific nerveinjury, and 1.02% of patients sustained permanent injury after abdominoplasty. In addition, 7.67% experienced decreased sensation, 1.07% reported chronic pain, and 0.44% reported temporary weakness or paralysis. Nerves directly injured were the lateral femoral cutaneous (1.36% of patients) and iliohypogastric (0.10%) nerves. Nerves injured from surgical positioning were the brachial plexus (0.10%), musculocutaneous (0.10%), radial (0.05%), sciatic (0.19%), and common peroneal (0.05%) nerves. Conclusions: Although our results showed a low incidence of postabdominoplasty nerve injury, the lasting impact on affected patients' quality of life can be significant. Appropriate and timely treatment by a multidisciplinary team is critical to optimize patient outcomes. Better reporting of nerve injuries in future studies of abdominoplasty will provide more accurate information about the incidence and consequences of these injuries. Level of Evidence: 4.

KEYWORDS:

abdominoplasty, aesthetic surgery, body contouring, chronic pain, cosmetic surgery, nerve injury, surgical complications

A large body of evidence shows that chronic pain

A large body of evidence shows that chronic pain is associated with disruption of a range of body-related cortical representations. There is some evidence that this disruption contributes to, or maintains, chronic pain. The theory that the disruption reflects maladaptive neuroplastic changes underpins treatments that aim to normalize cortical representations as a way of treating chronic pain. 

This review has touched briefly on some of the changes that occur in the brain when pain persists, and which present barriers to successful recovery. The relation between pain and cortical reorganization has been observed in many chronic pain states. It is not only limited to sensory and motor representations but it could result in disruption across many efferent systems. 

Knowledge about these changes as a result of persistent pain, could provide more insight in why in some patients recovery is delayed. Although the mechanisms behind are not always as clear and straight forward, Treatments that target sensory and cognitive representations using sensory and motor strategies show functional and symptomatic benefits > from Moseley et al.; Neurorehabil Neural Repair 26 (2012) 646 652 . All rights reserved to Sage Journals.