You're right to be concerned about your diabetes and if you read everybody else's response, it's clearly ok to do the surgery. An in-person consultation will be needed to find the details of your condition and make the ultimate decision of the safetly of this surgery for you.
In my patient population, I'll proceed with surgery as long as their diabetes is well under control and they are a good candidate for the surgery. If your diabetes is not well controlled or you've just not really been checking it, then I would first go about obtaining a Hemoglobin A1C to confirm that your blood sugar levels have been reasonably controlled and I'd review your metabolic profile. These are simple labs that are done routinely prior to surgery for a patient like yourself.
You're already familiar with the possible complications, that doesn't mean that you're going to have them though. Everything lies within a range and your diabetic condition (diet controlled vs subcutaneous insulin pump) is no exception.
One last comment is that your surgeon can take some precautions himself as well. The surgery can be designed to be more conservative by limiting dissection and minimizing tension with internal sutures and less resection, using a binder that fits properly, etcetera.
All of these minor details will help the overall picture. It's not uncommon for body contouring cosmetic surgery patients to have some sort of health condition so I suggest proceeding with your investigation by going to a board certified plastic surgeon.
How Safe is Tummy Tuck for a Diabetic?
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. Best wishes.
How safe is tummy tuck for a diabetic?
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!
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.
Pablo Prichard, MD
Diabetes and cosmetic surgery
This is a great question, and the answer is that as long as your sugar level is well controlled you should be okay for your tummy tuck. However, please be aware that your risk of wound healing complications is higher because of the diabetes. But, with safe surgical technique and careful post-operative care you should get a fantastic result. Good luck!
You will be able to have a tummy tuck but your wound healing may be more delayed than someone who is not a diabetic. You are at risk for more wound healing complications.
Having said that, if you are a diabetic that is extremely well controlled then it should not be an issue. You will need to keep your blood sugars below 120 and keep your HbA1c below 6. Those are the two most important parameters and what I look at before offering a patient who is a diabetic cosmetic surgery.
A diabetic can have Tummy Tuck safely
You should not be overly worried. If you can lose the weight, then it is very reasonable that, once your entire situation has been completely stable for awhile, you might go forward with body contouring procedures such as abdominoplasty. Be positive and optimistic and I'm sure you will do well.
Not as safe as in a non-diabetic but still possible
A tummy tuck in a diabetic carries more risk because of blood flow concerns than in a non-diabetic. Therefore it is critical that you choose a very experienced surgeon and do everything possible to optimize your health and weight preop to reduce the risks as much as possible.
The most important thing you mentioned is the fear that you will be left with hanging skin that would require a tummy tuck. So you grasp the importance of weight loss and control as a primary step in diabetic treatment. This might even make your diabetes go away or certainly less dangerous. Hopefully you will achieve this goal and attain an optimal healthy and stable lifestyle. Then your tummy tuck will be less risky. Depending on the severity of your diabetes (presence of hypertension, peripheral vascular disease, neuropathy, etc.), your may tummy tuck could potentially be no different that a patient without diabetes. Direct your attention to the more important goal of optimal health.
It is safe with tight control of your sugar
I've done tummy tucks on diabetics, even body lifts after massive weight loss. They healed well without complications. The important thing is that your sugar needs to be tightly controlled. You must follow your internist's instructions closely. Your insulin requirements can change after surgery. I find that in my patients the insulin requitrement decreases significantly. It is important that you loose the weight, again under medical supervision so your medications can be adjusted as you go through a physiologic "transformation". Best of luck.