My Daughter Has Had Kidney and Pancreas Organ Transplant Recently

Although I am not aware of problems with immunosuppression and botox injections, you should definitely have your daughter's specialists discuss and approve the use of elective cosmetic botox treatment.

As a few panel members already suggested, this question is best answered by your daughter's team of physicians to collaberatively provide the best decision.  

In our opinion, the most important factor in this scenario is that you indicated that your daughter had her transplant "recently."  Because organ transplanation requires diligent observation for rejection and other body reactions, it would seem prudent to consider these cosmetic procedures further down the road when she is considered stable.

 

 

Having said that, she is definitely at increased risk of complications including skin infection. Generally, I would recommend involving her internist in the decision to have treatment.  Concern and caution is warranted in approaching these types of treatment.  On the up side, the improved appearance is an emotional boost and that can make the slightly higher risk worthwhile provided she has the blessing of her medical doctors managing her transplants.

 

Caution is definitely advised in immunosuppressed patients when contemplating cosmetic procedures.  There is an increased risk of infection with procedures like fillers and laser resurfacing.

If Botox is reconstituted sterilely and the procedure is performed on clean and infection-free skin, and prophylactic antibiotics are given, I don't see a great problem with Botox.

As for fillers, if you recall, fillers like Sculptra were initially designed for HIV + patients, also immunosuppressed, for correcting lipoatrophy.

Consult a board certified dermatologist or plastic surgeon with training and experience in cosmetic procedures.  And include your transplant doctor in the discussion.  Between the three of you, you will come up with the right decision.

I wouldn't advise Botox in this case.

 

Ramtin Kassir, MD

Very difficult to medically advise in this extreme situation. A team approach by all her doctors including a PS is needed before I would entertain the injections. 

Botox is best not used in cases of immunosuppression. While the chances of adverse immune response are minimal a bad outcome would be devastating. A better idea is to use repeated light peels or multiple fractional laser resurfacing procedures.