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Should Diabetics Avoid Tummy Tuck?

I am a 19-year type 1 diabetic. I have not had any problems with my weight management through out the course of my life. I exercise regularly and keep tight control of my diabetes. I check my glucose levels about every two hours through out the day. I am now faced with a bulging mid-section after being pregnant and giving birth to a rather large baby (over 10 lbs). My HA1C test during pregnancy was 5.8. I have consulted with two plastic surgeons about getting a Tummy Tuck, and neither of them had a problem with me being diabetic. However, there was one plastic surgeon's office I contacted first and I was flat out refused. I was told that the surgeon would not even consider doing such a procedure on me because I am diabetic. She also warned that I should be cautious of anyone willing to perform the procedure on me. This news is unfortunate for me, because this doctor seems to be very skilled and have great training, not to mention does great work with belly buttons. I am wondering, is what I was told valid or was the person I spoke with speaking irrationally?

Doctor Answers (10)

Tummy tucks and diabetes

+5

Diabetics can have successful surgeries.

Diabetic patients should optimize their health and weight before having surgery. They should also optimize their glucose management. An internist should be on board and assist with the preoperative and postoperative glucose management. The surgeon and anesthesiologist should be skilled with the metabolic problems of diabetes and their management. The surgery should be tailored to the patient's health issues.

The risk of having surgery for diabetic patients will be slightly to moderately higher than nondiabetic patients, depending on how well controlled the diabetes is, the health of the patient. etc. Both the doctor and the patient must accept this risk.

Some doctors are unwilling to take on this risk. Others are ignorant of the issues involved.

If a doctor is not comfortable performing your surgery for whatever reason, you should move on.


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 92 reviews

This is a great question that deserves to be discussed at length with an experienced plastic surgeon

+4

Thank you for your great question? First allow me to say that it is imperative that you see a board certified plastic surgeon that is experienced in tummy tuck (abdominoplasty) procedures. Your physical examination and general health are very important factors. The input from your internist and/or endocrinologist is essential to prepare you for the operation and for monitoring postoperatively. In general, the tummy tuck procedure can be successfully performed in diabetics, but alterations and modification may be necessary to ensure your safety and avoidance of complications.

Again, this is a great question that deserves to be discussed at length with an experienced plastic surgeon.

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Diabetes is a relative risk

+3

If your diabetes is under good control, an abdominoplasty is possible. The main reasons for reluctance to operate on diabetic patients are healing problems, increase in infections, and concerns with glucose management. A carefully designed and meticulously executed abdominoplasty is certainly possible.

A surgeon might have to modify his procedure to fit this increase risk and to avoid undue tension or devascularization to the abdominal flaps. What you don't want to do is to try to talk a surgeon into doing something he or she is not comfortable doing.

Have a surgeon give you names of other diabetic patients who have undergone successful abdominoplasty in his or her practice.

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

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Sugar control is the key

+2

It sounds as if you keep a very tight control on your blood sugar and HgA1C. That is probably the most important part of minimizing your risks for surgery. You probably already know that diabetes affects many organ systems in the body, which does equate to some higher risks for surgery. Diabetes is NOT an absolute contraindication to elective cosmetic surgery as long as you understand your risk category. Some plastic surgeons, for many reasons, may elect not to operate on any patient with diabetes. There are many excellent board certified plastic surgeons in your area, so seek out one who is comfortable with the slightly higher complication rate that your condition represents. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 31 reviews

Carefully proceed with the right doctor

+2

IF you are done having children, you could proceed with a tummy tuck IF your diabetes is well controlled and IF you find the right doctor who understands the issues and the technical modifications needed to improve the safety for you, and IF you also understand the increased risk your diabetes places on your surgery.

There are many IF's involved here so you must find the right doctor. It is not an absolute contraindication to do a tummy tuck on a diabetic, just a big warning sign to be cautious!

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Should diabetics avoid tummy tuck?

+1
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. Measures will be taken to check levels as well as maintain proper glucose control with appropriate fluids and medications. 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!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Diabetes and Tummy Tuck

+1
Thank you for your post. Diabetes is a disease that should demand a healthy respect from both surgeon and patient in plastic surgery. It is a disease that affects the immune system and can increase the risk of infection, a disease that affects the healing potential of a wound and can cause opening of a wound, and is a disease of the circulation that can lower the blood flow to the operated tissue and cause necrosis or tissue death. This needs to be managed as follows:

1. Tight blood glucose control with diet, exercise, and medication. You need to see your internal medicine doctor regularly and make sure your diabetes is well controlled.
2. If you are overweight, then losing weight decreases your risk in tummy tuck surgery or any other surgery for that matter.
3. If you have high blood pressure, this needs to be managed and well controlled by your internal medicine doctor as well.
4. ABSOLUTELY NO SMOKING!
5. Consider with your surgeon HyperBaric Oxygen therapy pre- and post-op.
6. Make sure you understand from your surgeon and anesthisiologist what medications you should take or not take prior to surgery.

It is very possible to have a great outcome as a diabetic following tummy tuck surgery, but minimizing the risk is the most rational way of accomplishing this.

Best Wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 27 reviews

Should Diabetics Avoid Tummy Tuck?

+1

Well controlled diabetes is not a contraindication to tummy tuck surgery and/or other elective plastic surgical procedures. Always best to check with your primary care physician or endocrinologist for “medical clearance” prior to surgery.  Managing your diabetic medications around the time of surgery (to avoid hypo as well as hyperglycemia), while you will have altered oral intake, will be important.  I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 722 reviews

Diabetics and Tummy Tucks

+1

The performance of a full tummy tuck involves the separation of the tummy skin from ALL its underlying direct (perforators) blood supply and tightening the stretched out underlying abdominal muscles followed by the trimming of the excess skin and re-creating the belly button. For all of this to heal properly afterwards, you must have ample and effective circulation in the tummy skin and adjacent regions.

It is a well-acepted fact that diabetics have wound healing complications which are related to a reduced effective blood flow. While keeping your HgA1C within normal limits and your sugar controlled will reduce higher complication rates, in my opinion, everything else being equal, you will still take on a higher likelihood of complications than someone with your history who is not diabetic.

Being cognizant of the fact that a Tummy Tuck is a cosmetic procedure (meant to improve appearance - not restore function or save life) incurring complications by such a procedure needs to viewed critically by both surgeon and patient.

Just because a surgeon refuses you does not mean that he did not "like" you. Maybe he had adverse experiences in the past which taught him not operate on diabetics.

Just because another surgeon chose to operate on you does not mean that he is your friend. Maybe he is more interested in the financial rewards of doing your operation or maybe his past experiences with diabetics has been favorable.

Think about it and do your homeword.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

Tummy Tuck and Diabetes

+1

While diabetes is not an absolute contraindication, I would perform the surgery on an individual with diabetes as long as their sugars are well-controlled. Yes, they do have a higher risk of complications. On the other hand, I think you are a bit young at 19 to have a tummy tuck. If you are contemplating having more children, then I would wait.

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