Eyelid Surgery Advice for a Diabetic?

Question

Any advice for a diabetic having eyelid surgery for upper eyelids and bag under eyes?

Tanveer Janjua, MD · Answer

Infection is the main concern but not a contraindication.  Here are the steps you need to take before having the surgery.
1. Optimize glucose control by working with your family physician or endocrinologist.
2. Make sure to start an oral antibiotic 3 days before surgery
3. Get an intravenous antibiotic on the morning of surgery just before the surgery starts.
4. Make sure you surgeon uses Betadine Ophthalmic to clean out the eyelid skin before and surgery and rinses them at the end with BSS.
5. Resume your oral antibotics after surgery and keep taking them until you finish.
Regards

Tom J. Pousti, MD · Answer

Well controlled diabetes is not a contraindication to eyelid 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 sugar level around the time of surgery (to avoid hypo as well as hyperglycemia), while you will have altered oral intake, will be important.

When the time is right, seek consultation with well experienced board certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you would be pleased with.

I hope this, and the attached link, helps.

Lewis Albert Andres, MD · Answer

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!

Michael A. Persky, MD · Answer

Hi Barb,
Make sure that your diabetes is under control.  You need to see your diabetes physician before surgery and make sure that there is communication with your eye lid surgeon.  By taking measures before, during, and after your surgery, your blood sugar levels should be managed and you should do very well.
Diabetics may take a little longer to heal, and are more prone to infection, but infection with blepharoplasty is almost unheard of.
Good luck, be well, and enjoy your refreshed eyes.
Dr. P

Rafael C. Cabrera, MD · Answer

no problem as long as you are not brittle and have no occult cardiac disease. you should get the blessing of your MD and consider local with just a little sedation to avoid pulmonary issues. ironically, there is no study showing poor healing in elective surgery in diabetics under good control, just increased risk of cardiac complications.

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