Cosmetic Surgery in Solid Organ Transplant Patients: Is It Safe? – A Retrospective Analysis of Plastic and Reconstructive Operations in Organ Transplant Patients

Goals/Purpose: In 2011, 26, 245 organ transplants were performed in the United States. The long-term survival of these patients has increased dramatically over the past few decades due to advancements in surgical technique and immunosuppressive therapies. As a result, the number of these individuals seeking elective, cosmetic procedures performed by plastic surgeons is rising. The safety of these additional surgeries in transplant patients has yet to be thoroughly defined. The goal of this study was to examine the surgical and safety outcomes of elective, cosmetic plastic surgery operations in immunosuppressed transplant patients.

Methods/Technique:  A retrospective study was conducted on organ transplant patients who underwent cosmetic plastic surgical procedures at Yale New Haven Hospital between January 1995 and December 2011. Hospital records were reviewed for surgical details, outcomes, immunosuppressive medications and post-operative complications such as infection, wound dehiscence, skin/flap necrosis and delayed wound healing.

Results/Complications: 16 independent organ transplant patients were identified, undergoing a total of 23 post-transplant cosmetic operations performed by plastic surgeons. Transplanted organs included kidney (n=13), liver (n=2) and heart (n=1). Cosmetic plastic surgery operations included: 8 breast operations, 7 soft tissue lesion excisions, 5 panniculectomies and 3 rhytidectomies. Immunosuppressive regimens included prednisone (n=18), tacrolimus (n=11), MMF (n=10), cyclosporine (n=5) and azathioprine (n=4).  Following the 23 operations, there was only 1 reported complication of uncontrolled pain following a panniculectomy. There were no reported instances of wound healing complications or infections.

Conclusion: Elective cosmetic surgical procedures can have successful outcomes with minimal wound healing complications in carefully selected organ transplant patients.