I have been on various dosages of prednisone for 5 years due to an autoimmune disease, and I may never be able to get off. My face has become completely round and I am most self conscious about my neck and chin area that is extremely fatty. Currently I have been on a dosage of 10mg oconsistently for the last year and It may stay this way. Is there anything I can do to help?? How much would a procedure cost? Thank you
May 7, 2022
Answer: Prednisone and facial aesthetics There are lots of reasons patients should avoid being on prednisone for long periods of time if possible. With time the pituitary gland and adrenals compensate and produce less cortisol making the prednisone led effective. I’m not a rheumatologist but consider making sure your management is up-to-date and there are no alternative medication you can take take it off the prednisone. Your picture just shows the lower one third of the face and when we talk about moon face or Cushing‘s appearance it’s much more than just how the chin and neck looks. Based on your picture it looks like you have an underdeveloped mandible in relationship to your maxilla. You may be an excellent candidate for a sliding genioplasty or chin implant combined with Liposuction. Doing elective procedures and patients who take prednisone or have for many years can be tricky and it needs to be coordinated between your rheumatologist and plastic surgeon. We can’t really make an assessment for facial aesthetics based on such a limited picture. I suggest having a few in person consultations with local board certified plastic surgeons in your area or consider posting with proper facial pictures. Look at how plastic surgeons do facial before and after pictures to get an idea of what we need to make an assessment. Basically frontal and side views of the full head and face without facial expression. Best, Mats Hagstrom MD
Helpful
May 7, 2022
Answer: Prednisone and facial aesthetics There are lots of reasons patients should avoid being on prednisone for long periods of time if possible. With time the pituitary gland and adrenals compensate and produce less cortisol making the prednisone led effective. I’m not a rheumatologist but consider making sure your management is up-to-date and there are no alternative medication you can take take it off the prednisone. Your picture just shows the lower one third of the face and when we talk about moon face or Cushing‘s appearance it’s much more than just how the chin and neck looks. Based on your picture it looks like you have an underdeveloped mandible in relationship to your maxilla. You may be an excellent candidate for a sliding genioplasty or chin implant combined with Liposuction. Doing elective procedures and patients who take prednisone or have for many years can be tricky and it needs to be coordinated between your rheumatologist and plastic surgeon. We can’t really make an assessment for facial aesthetics based on such a limited picture. I suggest having a few in person consultations with local board certified plastic surgeons in your area or consider posting with proper facial pictures. Look at how plastic surgeons do facial before and after pictures to get an idea of what we need to make an assessment. Basically frontal and side views of the full head and face without facial expression. Best, Mats Hagstrom MD
Helpful