Intercostal neuralgia may develop following breast augmentation. The authors describe a woman who suffered 2 years of severe pain associated with cutaneous hypaesthesia in a T3-T5 distribution. Serial, placebo-controlled T3-T5 dorsal root nerve blocks provided temporary pain relief. The patient experienced immediate and lasting pain relief (34 months) following bilateral T3-T5 dorsal rhizotomies. This case provides anectdotal evidence that dorsal rhizotomy is a beneficial intervention for refractory intercostal neuralgia. © 2010 Wiley-Liss, Inc. Microsurgery, 2011.