Lupus Post-Transplant Patient - Is it possible to have tummy tuck, arm lift, butt lift and to fix my nose?

I don't doubt that you have the loose skin that needs excision and you would benefit from tummy tuck, arm lift and butt lift. However, if you are on immunosuppresent medications because of the transplant (which just about everyone has to be on), these get in the way of healing wounds/tissues and increase the chance of infection. This is why most plastic surgeons will generally not take on a case in a post-transplant patient because of the increased risk of complications. It is unfortunate and I understand where you are coming from, but I think you will have a hard time finding a plastic surgeon to do the case. Best of luck to you on your journey.

Dear LupusWarrior1989,
it is hard to tell for sure without an examination. You will need to get a clearance from your doctor prior to surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

You will need to get medical clearance for an operation that will take 5-6 hours. You will not be able to do everything at one time. I recommend doing the arm lift, nose and tummy at one time and then do the butt lift later.

Best Wishes,

Gary Horndeski, M.D.

Thank you for reaching out with your questions. First, congratulations on your weight loss – that's a significant achievement!

The procedures you're considering, such as a tummy tuck, arm lift, and butt lift, are all aimed at removing excess skin and improving contour, which is often needed after substantial weight loss. It's completely understandable that you would want to explore these options after your hard work and dedication.

However, as a patient with Lupus and a history of renal transplant, it's crucial to approach these procedures with additional caution. Lupus, as an autoimmune condition, and the immunosuppressive medications often taken post-transplant can affect your ability to heal and fight infections. This doesn't necessarily exclude you from these procedures, but it does mean that careful planning and close collaboration with your transplant and rheumatology teams would be essential to ensure your safety.

As for your nose, it's also possible to correct a perforated septum surgically. This procedure, called septoplasty, is typically performed by an ENT (Ear, Nose, Throat) specialist or a plastic surgeon with expertise in rhinoplasty. Again, your Lupus and transplant status would need to be considered in planning such a procedure.

Ultimately, the best first step would be a consultation with a board-certified plastic surgeon who can work in conjunction with your other medical providers. They can perform a thorough evaluation and discuss your specific goals, health status, and any potential risks to come up with a plan that is safe and effective for you.

Thank you for your question. I wish you the best of luck as you explore these possibilities. Take care and remember, your health and safety should always be the priority.

Sincerely,
Dr. Katzen

A tummy tuck with a butt lift is a lower body lift. Even in very thin patients who've lost most of their body fat require 5 hours, and the average time is 6 to 7 hours. An arm lift will requires another 2 to 3 hours. A complex rhinoplasty may take 3 to 4 hours. The combination of all three is far beyond what is considered safe in a renal transplant patient with SLE. I would suggest breaking up the body from the face, and if determined unsafe, breaking up the body surgery into two stages too. This is all hypothetical and determination of medical safety for your case would be performed by your transplant and SLE specialists in conjunction with your plastic surgeon.

You can certainly have plastic surgery even with a renal transplant. Set your priorities and don’t do too much at one time depending on recommendations along with consultation with your kidney doctor

If your medical doctor clears you for surgery, then you could probably have cosmetic procedures. However, they cannot be done all at the same time. You may need to see an ENT surgeon to repair your perforated septum.

Congratulations on your impressive weight loss and all that you've endured! Due to your medical history you will need to be evaluated individually to determine if you are a candidate for surgery. You will need to get clearance from your specialists as well. If you are a candidate for the procedures that interest you I encourage you to seek only board certified plastic surgeons and to have your procedure performed in an accredited facility. You may want to consider breaking these procedures into stages for safety and more optimal outcomes.

With history of lupus and renal transplant, I would be measured and careful with choice of surgery … please ensure a thorough pre-operative work up, specialist anaesthetist who is mindful of your medications including steroids, restrict to one anatomical area correction per sitting, limit operation time to 4 hours maximum and meticulous post operative care with regards to wound healing and scar care. Also anticipate that you will need revisison procedures eg excision of dog ears, revision liposuction along the journey.

I cannot speak for other surgeons, but I feel you are too high risk for a cosmetic procedure.
Beware of any surgeon willing to perform surgery without first getting medical clearance from your rheumatologist and kidney specialists.