Do I Need to Be Cleared by my PCP or Endocrinologist Before Surgery for a TT?

Your endocrinologist should be informed of your choice to proceed with abdominoplasty and will communicate with your surgeon about any special metabolic issues in the perioperative period.

Thank you for your question.  If you glucose control is normal and your A1C is below seven, then your risks of infection and healing problems are about the same as anyone else. It is helpful to get peri-operative instructions for your insulin management from your endocrinologist as the stress of surgery can cause alterations in blood sugars.  With cooperation between the endocrinologist, anesthesiologist and surgeon you should be able to safely have this elective procedure. Best wishes.

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

I would suggest you do obtain a preoperative medical clearance from your endocrinologist or internist prior to your surgery.  While I am sure your surgeon and anesthesiologist are experienced in caring for diabetic patients in the OR, it is helpful to have insight from a medical doctor who has known you well on a long-term basis.   Being a tightly controlled diabetic with an insulin pump and a normal A1C should not preclude you from undergoing a tummy tuck, all other factors being equal.  Good luck!

I would discuss your plan to have an abdominoplasty with your endocrinologist.  It will be important to have him on board to manage your type I diabetes and insulin requirements after surgery.  

We have performed safe tummy tuck on diabetics, some with insulin pumps. The key to safety is medical clearance and participation from your primary care physian. Your surgeon should be prepared for this and with coordination, you should be a candidate for the procedure.

Based upon your statement, I would not necessarily want a clearance, but would suggest communicating with your primary to that if there were management problems your doc would not feel out of the loop. 

When you make your appointment let the receptionist know about the medical issues. It seems doubtful that a surgeon would turn you down on that basis.

All the best. 

Tummy tuck is a very safe procedure when performed by qualified plastic surgeon and monitored by a good anesthesiologist.  Your plastic surgeon will examine you and and review your medical and surgical history.  If she/he determines that you would need medical clearance, she/he should ask for it.  In any surgery, safety is our primary concern as well as making our patients achieve their cosmetic goal.  It is a good idea to get a medical clearance by your PCP (or endocrinologist) who knows your medical condition the best.  If your PCP thinks that you are a high-risk for elective surgery, it is best not to pursue it.