1105 - "When Beauty Hurts: A Rare Neurological Complication of Cosmetic Abdominoplasty"

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

NB

Naciye Bilgin Badur, MD

Resident
Montefiore Medical Center Albert Einstein Medical School
Bronx, New York, United States

Co-Author(s)

CM

Christine Mathew, MD

Resident
Burke Rehabilitation Hospital
white plains, New York, United States
AB

Adam Betcher, MD

Resident
Montefiore Medical Center Albert Einstein Medical School
bronx, New York, United States
MC

Moorice Caparo, MD

Assistant Professor, Attending
Montefiore Medical Center Albert Einstein Medical School
Bronx, New York, United States

Submitter(s)

NB

Naciye Bilgin Badur, MD

Montefiore Medical Center Albert Einstein Medical School
Bronx, New York, United States

Case Diagnosis: Syringomyelia and Cauda equina syndrome

Case Description: A 33-year-old woman underwent a six-hour abdominoplasty with liposuction in the Dominican Republic. Postoperatively, she developed immediate right leg numbness and weakness, requiring wheelchair use, along with transient bladder and bowel retention that resolved after two weeks. Despite improvement with physical therapy, she continued to experience right-sided leg weakness, numbness, and pain two months later. Examination revealed reduced strength in the right lower extremity, diminished reflexes, and decreased sensation. MRI of the thoracic spine showed a fluid-filled cavity in the right conus medullaris suggestive of syringomyelia or ventriculus terminalis. Lumbar MRI revealed hyperintense T2 signal at the conus and mild disc bulges at L4-L5 and L5-S1. EMG demonstrated polyradiculopathy affecting the S1/S2 segments with severe distal motor axon loss, consistent with cauda equina syndrome.

Discussions: Syringomyelia and cauda equina syndrome are rare complications of cosmetic procedures, particularly abdominoplasty. Syringomyelia, often congenital, may also arise from trauma or CSF flow disruption. Cauda equina syndrome is a rare but recognized risk of neuraxial anesthesia. In this case, the extended surgical duration and potential anesthetic complications may have contributed to both pathologies. Differentiating syringomyelia from a ventriculus terminalis on imaging is critical due to differing management strategies. Syringomyelia, when symptomatic, may necessitate surgical decompression to relieve cerebrospinal fluid (CSF) pressure, whereas a ventriculus terminalis often requires only observation unless there is evidence of progression. In this case, the patient’s constellation of neurological symptoms pointed toward a diagnosis of syringomyelia as ventriculus terminalis rarely presents with such severe symptoms.

Conclusions:

This case highlights an unusual combination of syringomyelia and cauda equina syndrome following abdominoplasty, likely linked to neuraxial anesthesia. It underscores the need for careful anesthetic technique and thorough patient counseling—especially in procedures performed abroad. Early recognition and multidisciplinary management are essential to optimize outcomes and prevent long-term neurological deficits.