Your Questions

Q: Dr. Eppley, I had a kidney transplant six years ago. My transplant team believes I could have a procedure to diminish the abdominal-flanks area. The side where the kidney is is larger. I weight 195 lbs and am 5’11”. I dislike being lopsided and have exercised (I am in pretty good shape). I was interesting in you because of your experience with a few transplant patients. There are great surgeons where I live but I trust you more.

A: I can see in your picture the protrusion/lop sidedness of the left side. That is the same side as your kidney transplant as can be seen by the location of the oblique abdominal scar. However, the bulge that is sticking out I doubt is where the kidney is. Generally that would be under the incision away from the bulge sitting on top of the abdominal fascia. Thus I do think that the protrusion could be reduced by a combination of liposuction and skin excision. (tummy tuck) The skin excision could extend across the whole abdominal incision as there may be skin excess there as well.

You would be on some level of immunosuppressive medication currently and we compensate for that by giving ‘stress steroid’ dosing at the time of surgery. Any other considerations/needs based on your transplant doctors input is also important.

I would estimate that you would need to be here no more than three to five days based on whether the placement of a surgical drain is needed. (which I would work towards not using.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am a two time kidney transplant recipient, both from cadaver donors.

Due to both surgeries, my abdomen healed fine, it’s just that it healed in the shape of the letter V so to speak, and I have this big pouch that looks like a giant lip at my lower abdomen, no matter how much exercise I do, it is not going anywhere. I have considered cosmetic surgery for years, but was not aware that I could have it due to my transplants. I did gain weight, but I managed to lose 45 lbs. but I still have problem areas, that I feel I need to have corrected to help my appearance more. I am comfortable with myself, I just want to look as good as I feel.

A: Thank you for your inquiry and glad to hear that you are doing so well. A kidney transplant patient can have an operation like a tummy tuck safely and effectively. This would require that you have clearance from your nephrologist, have good blood counts (e.g., normal white blood cell count as an indicator of immunocompetence) and that the tummy tuck be modified to eliminate muscle plication and simply remove the skin and fat overhang. I would be happy to review any pictures that you may care to send to see if this would be a good option for you. It would also be helpful to know the location of the cadaveric kidney which usually in a subcutaneous abdominal location.

Dr. Barry Eppley

Indianapolis,Indiana