I was intrigued by a the below email inquiry by a kidney tranplant patient who lives on the east coast.  I was a transplant surgeon for 20 years and know that even with a successful transplant many patients struggle with how their bodies and faces change due to the anti-rejection medications such as steroids.  In fact in some young teenage patients they are tempted to stop their anti-rejection regimen because of how much this change in body self image affects them adversely.  Below is the question and my response.  I wish this woman good luck with both her life saving transplant and in dealing with her self-image concerns.

Hello _____,

Thank you for your inquiry:
Dr. Tom,
I had a kidney transplant in 2001 (renal failure etiology unknown, no disease etc.) I was wondering if laser liposuction would be safe in the abdomen of a kidney recipient. I am very unhappy with they way the fat on my stomach has grouped, superior to the transplant. Thank you

My reply:

Firstly congratulations on a successful kidney transplant.  Transplant surgery is very dear to me as I actually started my surgical career by developing a renal transplant center here in Santa Rosa, CA.  Fighting off weight and girth is difficult especially if you are on steroids.  Obviously a healthy diet and exercise are key to any successful cosmetic outcome.

 If you review our web page on SmartLipo http://laserandvein.com/smartlipo.php in the middle of the page is a Body Mass Index chart.  I limit our candidates for SmartLipo to the BMI of 28 or less range.  This is because SmartLipo is for contouring and not for large weight loss/fat removal.  I have actually achieved significant girth reduction for many patients but must always try to manage their expectations.    You indeed may be a good candidate for SmartLipo depending on some caveats below.

 A careful examination of your abdominal wall especially where the transplanted kidney is needed to rule out any type of incisional hernia and to assess the elasticity of your skin.

 You did not mention your age nor any other medical conditions.  This would also have to be taken into consideration.

 If you are on large doses of steroids your healing will be impaired.  Even if you are on low doses of steroids then the skin tightening may be affected.  And of course with any transplant patient one is always careful about possible infection. 

Nonetheless, SmartLipo is a much less invasive way to contour your abdomen.  I do know that the body changes that occur with transplantation especially due to the drugs can be very disturbing.  It can affect one’s self image and confidence. 

You live on the east coast.  There are I am sure good cosmetic surgeons there who could evaluate you.  If you ever are here in Northern California we would be happy to meet you.  Our consultations are complementary.  We would first have you speak to Patty our SmartLipo liaison who would help to determine your initial candidacy.  Her phone number is (707) 542-8346 ext. 305.

 Best of luck with your kidney transplant and your cosmetic concerns.

 Walter W. Tom, MD, FACS