Type 1 Diabetes and breast augmentation after care - what is the health criteria for safety and the expected recovery time?

Question

Hi, I am interested in learning more about breast augmentation and would like to understand 2 things related to Type 1 Diabetics: 1. What is the health criteria to determine if a type 1 diabetic is safe to undergo surgery 2. What is the expected recovery time for exercise (pilates specifically if that detail matters)? Thank u

Gary DeCesare, MD · Answer

In general, it is 6-8 weeks before it is safe to be doing intense exercise involving the chest muscles. Even then, you will need to progress with intention while listening to your body. Re diabetes, their must be medical clearance from the patients primary and endocrinologist. Adequate blood glucose control is paramount.

Daniel Barrett, MD · Answer

Dear patty johnson,

I understand your concern. It is best that you consult your plastic surgeon regarding post operative care and management (i.e including massage techniques and timing) specific to your case. Your surgeon knows your condition well and has preferences on when and what to use for faster healing and recovery. Post operative care and management depends on the type of surgery performed and the technique used during surgery among other factors.
It is best, however, that you follow your plastic surgeon's advice on post operative care management for a smooth and faster healing and recovery.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Sibel Atalay, MD · Answer

Those are such thoughtful questions, and it’s wonderful that you’re thinking carefully about safety and recovery before moving forward. For women with type 1 diabetes, breast augmentation can absolutely be an option, but the most important factor is good blood sugar control. Surgeons usually look at your overall health and your HbA1c, ideally kept in a stable range, since that lowers the risk of healing issues or infection. As long as your diabetes is well managed and you don’t have major complications, many women are able to safely undergo surgery with the right care and planning.
When it comes to recovery, every body heals a little differently, but there are some general timelines to keep in mind. Gentle walking is encouraged right away, as it helps circulation and healing. Lower-body or light movement can usually begin around two to three weeks, while gentle Pilates that avoids the chest area may be possible around four weeks. For full Pilates, especially exercises that engage your chest muscles, most women are cleared closer to six to eight weeks. Since you have type 1 diabetes, your surgeon may recommend taking things just a touch slower to make sure healing is solid, but with good glucose control, you can expect to follow a fairly typical timeline.
The best part is that with a supportive surgical team and careful attention to your health, you can look forward to a smooth recovery and beautiful results, all while keeping your safety front and center.

Donovan Rosas, MD · Answer

The best candidate for elective cosmetic surgery have been optimized from a health perspective.
They should be relatively healthy. Medical clearance is often a pre-requisite.

With regards to DM, good blood glucose control is recommended. HbA1C levels (marker of long term control) should be within normal limits,

Augmentation recovery is typically 6-8 weeks. I allow patients to begin light exercise at 4 weeks with a slow escalation to baseline over the next 2-4 weeks.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Sean Fisher, MD · Answer

many patients with diabetes can undergo surgery safely, if it is well controlled. Most surgeons will have a cut off for A1c ( less than 7 is my cut off), for considering this type of surgery. Assuming your diabetes is well controlled, recovery should look the same as for those patients that do not have diabetes. Overall recovery for your augmentation is somewhat dependent on the exact operation (above or under the muscle placement). Generally 4-6 weeks of limited activity is required after an augmentation, however patients are typically back to their normal routine within a few days after this operation. 
Sean M Fisher MD Aesthetic Plastic Surgeon Seattle, WA

Tuan A Truong, MD, FACS · Answer

Thank you for your question. Being diabetic does not disqualify you from surgery - rather, certain steps will need to be followed before and after surgery. As long as your blood sugars are controlled, and having a good HbA1c (less than 6 for many surgeons), the risk for complications is low. Expected recovery time is typically 6 weeks before unrestricted activities can be resumed. Good luck with your journey!

Camille Cash, MD · Answer

Thank you for your questions.  Before determining if you are a candidate for breast augmentation lab work will likely be ordered.  We will want to know your HbA1c and want your blood sugars in good control.  After surgery you will want to limit strenuous exercises for about six weeks.  It's important to get clearance from your surgeon before resuming activities as time frames for returning to exercise can vary based on how you're progressing through recovery.  I've included a video I hope you find helpful.

Mark Magnusson FRACS (Plast) · Answer

Hi Patty and thanks for your question. As the father of 2 T1D children I can understand your concerns.If your DM is well managed with a good HbA1C then initially it is a matter of managing your BGL while fasting before surgery. The process depends upon whether you are on a pump or injections/pens. You will need to be well coming into your surgery and usually a diabetic will go first on the operating list. With the natural stress hormones the body produces with surgery, you will likely need a little more basal insulin following surgery for about 24 hours, but a breast augment is usually only a mild insult to the body from a stress response perspective so this is often subtle.Your facility/anaesthetist will co-ordinate specifics for you. If on pens or injections, in general half the daily long acting and no short acting while fasting, monitoring your BGL every 2 hours if not on a CGM.Life is much simpler on a CGM and pump. Easy to monitor your BGL and the pump will automate your basal insulin. Small hypo-treats available!During surgery and initially in the post-op recovery some anaesthetists will prefer you to be off the pump and allow them to share your BGLs from your phone and correct as needed. However this is a short procedure of about 1 hour. Without a CGM or pump, regular BGLs till eating and a sliding scale of insulin accordingly.Certainly achievable, not a huge stress response with this surgery, just needs to managed thoughtfully and you know your DM better than anyone. Surgery is a partnership, your thoughts should be taken into consideration regarding your DM just as your recovery should be directed by your surgeon.Regarding getting back to pilates. Depends upon the surgeon, implant pocket (above or below the muscle) and time. Pilates includes significant upper body activation. For my patients, full range of movement within a couple of hours after surgery. But this is movement not exercise. Above the muscle, 8 weeks for all activities. Below the muscle, 8 weeks for moderate upper body exercise and 12 weeks for max exertion. These are guides of course and your surgeon is the best person to talk to.Best of luck.

Type 1 Diabetes and breast augmentation after care - what is the health criteria for safety and the expected recovery time?

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