ABDOMINAL WALL DEFORMITY
STATUS POST COBALT RADIATION FOR NEUROBLASTOMA STOMACH LEFT ABDOMEN
Below is the extremely interesting case of a patient who is now four weeks postoperative for augmentation mammoplasty as well as abdominal contouring as well as thigh liposculpture at six months of age undergoing radiation therapy for neuroblastoma of the gastric or stomach region. The patient on preoperative photograph has loss of fatty tissue and some muscle development along the left lateral wall. The umbilicus is shifted to the left. She was very disturbed in her clothes through the years of the extra fat along the iliac crest roll or hip lower flank area as well as the periumbilical lower abdomen and epigastric area which rolled up upon her pants. She also is very unhappy with the gynoid appearance of her lower third showing severe lipodystrophy of both the inner and outer thigh in a pear-like figure. The patient underwent abdominal CT scan showing no fascial defects or hernias on the abdominal wall along the right side of the umbilicus and therefore she was safe to undergo tumescent liposuction of the epigastric right area and the hip as well as of course to sculp the thighs.
The patient underwent augmentation mammoplasty procedure with a 210 cc saline implant through the subpectoral periareolar approach as well as tumescent liposuction removing over 1.2 liters of fat of the periumbilical, right hip, lower flank and contouring of the inner and outer thighs.
The patient is ecstatic with her results. Most importantly, when she wears her clothes and pants, the fat no longer rolls up above the jean line. She underwent the Linder Bi-directional Flank Liposuction Technique, both in the vertical and oblique plane on the right hip and smoothed out the lower epigastric area. The thighs are beautifully contoured and she cannot be happier.
This is an extremely interesting case as a young six-month old with a very rare tumor of a stomach. She had undergone cobalt and radiation therapy which caused necrosis and complete atrophy of the left abdominal wall. It is always a challenge, but it is very pleasing to be able to help patients not only with cosmetic appearance, but certainly the functional impairments that they have throughout their everyday lives.