Face Lift After Kidney Transplant?

Question

I am 36 years old and I have the typical "chipmunk cheeks" caused by the predisone that I take for my kidney transplant. I am thin, but I have fat and loose skin under my chin and around my neck that makes me look much heavier than I really am. Is there anything I can do to reduce the fat and loose skin that would be less invasive than a traditional face lift?

Jed H. Horowitz, MD, FACS · Answer

The time between having electoral #cosmetic surgery after a major surgery depends on the surgery. Its best to consult with the surgeon or specialist you recently had the major surgery with to gain perspective as to when cosmetic surgery can be scheduled.

Sam Naficy, MD, FACS · Answer

Long-term use of steroids does cause a 'moon face' syndrome.  This fat could be removed if you are able to get medical clearance from your doctor

Otto Joseph Placik, MD · Answer

The fat in the location you describe is located deep to the layer typically treated by non-invasive or minimally invasive techniques such as radiofrequency abalation (Thermage). This may make your skin appear even thinner which is undeseirable. Surgical removal of the buccal fat, possibly using an intra-oral approach, could be beneficial for this but does involve surgery. I do not recommend liposuction especially if you remain on prednisone.

Kevin Sadati, DO · Answer

Dear patient, I recommend a minimally invasive procedure for you. I have treated a few patients who had your situation. Conservative treatment is the best treatment. Laser lipo of the fatty pocket with laser resurfacing or Thermage would be a good option.

Stephen Prendiville, MD · Answer

As others Surgeons have noted, the first step in this process is a consultation with your Nephrologist and Transplant Surgeon. No cosmetic surgical procedure is worth sacrificing your health. It is possible that a neck lift will help you. Liposuction of the face is a very limited procedure due to the risk of contour irregularities.

Kenneth D. Steinsapir, MD · Answer

It is essential to understand that the drugs you take to preserve your transplanted kidney also compromise how you heal. You should have not cosmetic procedures without the blessing of your nephrologist and personal internist. With that said, focal liposuction of the face may be very helpful in shaping your face and can be done as an office procedure under local anesthetic.

William Portuese, MD · Answer

The chipmunk cheeks are caused from long term steroids and the fat gets deposited in the cheek area and in the subplatysmal space in the neck. A buccal fat pad removal combined with a neck lift could address fat removal from the neck. A neck lift will not address any loose skin in the neck. It is also important to make sure you have medical clearance from your transplant doctor prior to embarking on elective cosmetic surgery.

Robert Brueck, MD · Answer

I think liposuction might be an answer for your particular situation.I always tell my patients when you suction there may be some tightening of the skin but you could be left with some loose skin that may require a necklift later but lipo may be a good first step and if you are happy home run.

Francis R. Palmer, III, MD (retired) · Answer

Yes, the excess fat can be removed using micro-liposuction on the face and neck. This may be a good start. If after 3 months you decide to have the jowls (if there are any, no pics) and skin IMHO a minimal incision face Lift with the limited dissection could be performed. This can be done under local infiltration avoiding anesthesia which may be a requirement due to your kidney transplant. IMHO, you don't want extensive or aggressive surgery as prednisone does decrease the body's ability to heal after surgery.

Michael Elam, MD (retired) · Answer

If you had full clearance from your physician for a minimally invasive surgery liposuction would be your best bet for removal of the fat under the chin area. The fullness of the face from the steroid treatments may looked improved with the sculpting of the neck. All patients under steroid therapy need special care and should be cleared by their physician and during the preoperative phase should consult with the anesthesiologist who will be treating them or standing by for their procedure.

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