What are the usual parameters for a diabetic considering rhinoplasty ?

Question

I am 63, and a diabetic with a current A1C of 7.5. I would like a a nose job and know my A1C would have to come down some. What are the usual parameters for a diabetic considering rhinoplasty ? A doctor that has worked on some family members in Columbia, told me 5.9 for A1C.

Semih Yildiz, MD, FEBOPRAS · Answer

An A1C of 5.9 is not a universal requirement for elective rhinoplasty. Current diabetes guidance generally recommends a preoperative A1C below 8% within the previous 3 months, with an individualized risk-benefit assessment. Many cosmetic surgeons or surgical facilities may choose a stricter cutoff based on their own policy and the patient's overall risk.

Your A1C of 7.5 may fall within that broad guideline, but A1C is only one part of clearance. The surgeon, anesthesiologist, and clinician managing your diabetes should also review day-to-day glucose stability, kidney and cardiovascular health, blood pressure, medication use, smoking, infection risk, and healing history. Blood glucose is usually monitored before, during, and after surgery, with a common perioperative target of 100 to 180 mg/dL.

Do not rapidly lower glucose or change diabetes medications solely to reach a number without medical supervision, because hypoglycemia also creates risk. Ask the operating surgeon which facility-specific cutoff applies and obtain a coordinated medication and fasting plan from your diabetes and anesthesia teams. Rhinoplasty can be considered when the diabetes and other medical conditions are stable and the surgical team agrees the elective risk is acceptable.

Gary M. Horndeski, MD · Answer

A rhinoplasty usually heals very well, even in patients with diabetes because of the good blood supply.  You will have to be cleared medically before having the procedure.

Best Wishes,

Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Safety and medical optimization should always be the number one priority before booking surgery. Make sure that you work closely with your primary care doctor and if you can obtain medical clearance, then you could likely safely proceed forward with surgery. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

What are the usual parameters for a diabetic considering rhinoplasty ?

Answers (3)

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