Carpal tunnel syndrome is the most common compression or entrapment neuropathy of the hand. The condition develops when the median nerve — one of the three main nerves providing motor and sensory function to the hand, alongside the ulnar and radial nerves — becomes compressed at the wrist by a thickened, inflamed transverse carpal ligament on the volar (palm-side) surface. The result is a recognizable cluster of symptoms that meaningfully affects quality of life and, when severe enough, hand function itself. The median age of onset is approximately 50, though carpal tunnel can develop earlier in patients with predisposing factors. At Los Angeles Plastic Surgery in Beverly Hills, Dr. John Anastasatos diagnoses and surgically treats carpal tunnel syndrome with the depth of peripheral nerve surgical training this delicate procedure specifically requires.

Dr. Anastasatos performs carpal tunnel release with the most directly relevant academic credential possible: he completed a fellowship in Hand and Upper Extremity Surgery and Microsurgery at the University of Alabama at Birmingham — formal subspecialty training in peripheral nerve surgery that few cosmetic plastic surgeons possess. He has presented academic work at UAB Grand Rounds on “The Microsurgical Repair of Peripheral Nerves” — directly relevant to the science of carpal tunnel release — and trained in plastic surgery under Dr. Luis Vasconez at UAB, one of history’s foremost plastic surgeons. With over two decades of facial and hand surgical expertise in Beverly Hills since 2007, he is board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS), and named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Symptoms of Carpal Tunnel Syndrome

Carpal tunnel symptoms typically develop progressively and most commonly include:

• Numbness and tingling in the palm, wrist, thumb, index finger, and long (middle) finger
• Weakness of grip in the affected hand, often noticed when opening jars or holding small objects
• Night pain that wakes the patient from sleep — a particularly characteristic complaint
• Daytime symptom flares triggered by repetitive use, driving, or holding a phone
• Hand clumsiness in advanced cases, with patients dropping objects more frequently

The pattern of symptoms — particularly the distribution covering the thumb through long finger — reflects the specific area of the hand supplied by the median nerve.

Treatment Options for Carpal Tunnel

Initial therapy focuses on conservative measures:

• Non-steroidal anti-inflammatory medications to reduce inflammation around the nerve
• Wrist splinting — particularly at night, when symptoms are often worst
• Activity modification and rest from repetitive hand-intensive activities
• Cortisone injections as a subsequent step when conservative measures are insufficient

When conservative treatment fails to provide adequate relief — which is common in moderate-to-severe carpal tunnel — surgery becomes the mainstay of therapy and offers durable, often immediate symptom resolution.

Carpal Tunnel Release Surgery

Carpal tunnel release surgery is highly effective and produces immediate symptom relief in most patients:

• Standard open approach — a 7-8 cm incision extending from the wrist to the palm, allowing direct visualization of the transverse carpal ligament
• Ligament division — the thickened compressive ligament is carefully divided to relieve pressure on the nerve
• Nerve examination — the median nerve is examined and freed from any constricting adhesions
• Tissue release — additional potential constricting tissues are released to prevent future recompression
• Closure — the wound is closed with a soft dressing applied
• Endoscopic option — the procedure can also be performed endoscopically when appropriate
• Sutures and dressings are removed at approximately 14 days post-surgery
• Symptom relief is typically immediate following the procedure

Anesthesia Options — Including Local Only

Carpal tunnel release can be performed under several anesthesia approaches:

• General anesthesia — for patients who prefer to be fully asleep
• Intravenous (IV) sedation — twilight sedation with local numbing
• Local anesthesia only — a unique technique Dr. Anastasatos offers in his practice, allowing patients who prefer to avoid general anesthesia to have the procedure performed entirely under local

The local anesthesia option is particularly valuable for patients who are afraid of general anesthesia or have medical conditions that complicate it.

Schedule a Carpal Tunnel Consultation in Beverly Hills

If you have numbness, tingling, or grip weakness consistent with carpal tunnel syndrome — particularly if symptoms are waking you at night — Dr. Anastasatos welcomes patients to the Beverly Hills office at 436 North Bedford Drive, Suite 202, Beverly Hills, CA 90210, for a private consultation. Contact Los Angeles Plastic Surgery to schedule a carpal tunnel consultation with Dr. Anastasatos.