CHRONIC, BURNING FACIAL-PAIN FOLLOWING COSMETIC FACIAL SURGERY

Chronic, burning facial pain as a result of cosmetic facial surgery ha s rarely been reported. During the year of 1994, two female patients p resented themselves at our Pain Relief Clinic with chronic facial pain that developed following aesthetic facial surgery, One patient underw ent bilateral transpalpebral surgery for removal of intraorbital fat f or the correction of the exophthalmus, and the other had classical fac e and anterior hairline forehead lifts. Pain in both patients was simi lar in that it was bilateral, symmetric, burning in quality, and aggra vated by external stimuli, mainly light touch. It was resistant to mul tiple analgesic medications, and was associated with significant depre ssion and disability, Diagnostic local (lidocaine) and systemic (lidoc aine and phentolamine) nerve blocks failed to provide relief. Psycholo gical evaluation revealed that the two patients had clear psychosocial factors that seemed to have further compounded their pain complaints, Tricyclic antidepressants (and biofeedback training in one patient) w ere modestly effective and produced only partial pain relief.