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Diabetes and Breast Reduction

Hi Im a 42 yr old ,and use insulin for my diabetes. I was wondering how my diabetes will affect surgery/ results? I have 48 DD/ E breast. I have been this size since I hit puberty at age 11. I have wanted a breast reduction most of my life. I have back, neck and shoulder pain. I also have deep grooves on my shoulders and often have rashes under breast. My biggest concern is nerve damage/ sensation and scaring.

Doctor Answers (17)

Diabetes and breast reduction?

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Hello! Thank you for your question! There are a few medical comorbidities that contribute to a higher risk during any surgical procedure including infections, wound complications, delayed wound healing, bleeding, anesthetic risks, etc. Diabetes is one that is known to have an increased risk for infections and wound healing issues. There are a number of both systemic and local host factors that can contribute to infections. Whether or not diabetics are truly at greater risk and the magnitude of the effect of diabetes on the risk of infection remain controversial. However, there is a known increased propensity to develop infections and delayed healing. Some of the hyperglycemia-related impairments on the immune response include vascular insufficiency, sensory peripheral neuropathy, autonomic neuropathy, and skin and mucosal colonization with pathogens such as Staphylococcus aureus and Candida species.

That being said, well-controlled diabetes should equate a minimal increased risk for the above and surgical procedures still safe and a reasonable decision. You should ensure adequate glucose control always, but also obtain medical clearance from your primary care physician that you are at an acceptable risk for undergoing a surgical procedure. Laboratory results such as HgbA1C is a good measure of control. Discuss all of your medical comorbidities and medication with your surgeon prior and discuss these risks. This procedure should still be very safe for you and hope for an uncomplicated course with an excellent result! Hope that this helps! Best wishes!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast reduction in diabetics

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Diabetics may undergo a breast reduction without complications if their diabetes in under control.  Many diabetics have peripheral neuropathy, which decreases sensation of the areolas.  If you have areola numbness now, it is possible that you may have areola numbness afterwards from the diabetes.  With a new technique (The Ultimate Breast Reduction) often the areola sensation can improve.  Shoulder, neck and back pain can also improve with this technique by the breast weight transfer to the underlying muscle.  This technique eliminates vertical scars used in lollipo or boat anchor reductions.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 125 reviews

Diabetes

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My only concern would be adjusting the insulin doseprior to surgery to avoid intro prestige hypoglycemia.  You should discuss the issue with both your surgeon and anesthesiologist per operatively.  The effect on healing and circulation to the skin and nipple will probably be negligible, although your surgeon might recommend antibiotics to reduce the risk of infection.  Overall the operation can be done quite safely in your case.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 11 reviews

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Breast Reduction can be done on diabetic patients

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Proper clearance form your internist,controlled diabetes and you should be fine to undergo a breast reduction. Patients with diabetes are at a higher risk of infection and with the right antibiotics and a close watch on the recovery you should heal without complication. Nerve damage/ sensation is unlikely. There will be scars that are red at first however those scars should heal into fine white lines. 

Z. Paul Lorenc, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 23 reviews

Diabetes and Breast Reduction

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Dear bigboobiesco,

This is not an uncommon situation and one that can be successfully addressed by getting everyone to work together as a team.  This means getting the doctor who is managing your diabetes to evaluate and clear you for surgery.  The anesthesia team needs to be consulted and prepared to manage your diabetes' needs before, during, and after surgery.  The plastic surgeon needs to be willing to see the patient on an increased level to ensure the wounds are healing well and there is no evidence of infection.  By working together, you should be able to have a very successful surgery.  

As an FYI, we performed this exact procedure on a IDDM patient on Friday and she is doing great.  Again, thanks to team prep and planning.  Hope this helps and best of luck with your surgery.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.0 out of 5 stars 18 reviews

Breast Reductuon safe with diabetes?

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We refuse to perform cosmetic elective surgeries on insulin users because thay all get some degree of wound healing problems.  That said, you probably would be better off without the rashes which eventualy will cause an infection anyway. Large breasts all have decreased sensation around the nipple already. All methods of reduction will aggravate that.

If you will reign yourself to accept the high probability of wound healing problems you will in the end be very glad you did it. Reduction patients are the most thankfull of all our patients because they not only look better but they feel better too. They are the ones still sending Christmas cards 10 yreas later. I have one still sending Christmas cards 40 years later!

 .  Dr Foster  Lake Tahoe Plastic Surgery

Lawrence Foster, MD
Sacramento Plastic Surgeon
3.0 out of 5 stars 12 reviews

Breast Reduction Can Be Performed Safely For Women With Dabetes.

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Breast reduction can be  performed safely for women with well controlled diabetes. Your primary care physician will play a vital role in a successful outcome. Preoperative evaluation including history, physical examination and laboratory tests (including hemoglobin A1c) will help to determine if you are a candidate for the procedure. Additional cardiac testing may be required to determine if you are medically cleared for the procedure. Your primary care doctor will also participate in the management of your diabetes during and after the procedure. With optimal control of your diabetes, complications such as delayed healing, poor scarring, and infection can be minimized.

Breast reduction has one of the highest patient satisfaction ratings of any plastic surgery procedures. Breast reduction not only improves the way you look, but also alleviates the symptoms of large breasts, including back, neck and shoulder pain, rash, grooving of the shoulders, and reduced exercise tolerance. I would recommend a consultation with a Board Certified Plastic Surgeon. Best regards,

Andrew Lyos, MD, FAC

 

 

Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 23 reviews

Diabetes and breast reduction

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Patients with diabetes have risks of complications. If you want to go ahead with surgery, your diabetes should be well controlled to minimize the complication rate.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Diabetes and Breast Reduction

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We frequently run into this situation, that is a diabetic patient who wishes to undergo elective surgery. Assuming your Hemoglobin a1C is at a good level and your doctor caring for your diabetes is on board, you should be able to undergo the surgery. You may be at a slightly higher risk of infection and in my practice we keep our diabetic patients on antibiotics before and for a few days after surgery. You should not be at any more risk for scarring or nerve damage than a non-diabetic patient if the above driteria are met. The above information would not apply if you are a smoker.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

Diabetes and breast reduction

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While diabetes, especially insulin-dependent diabetes, can generally affect healing and infection rates, when planned carefully and with the diabetes under control diabetes in of itself is not a contraindication from breast reduction. Make sure your surgeon and internist/endocrinologist communicate with each other to optimize timing and insulin dosage.

 

Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.