I’m diabetic – can I undergo plastic surgery?

QI am 50 years old and have diabetes since childhood. My friends told me to go for plastic surgery so I would look younger as my skin is sagging. Can I undergo cosmetic plastic surgery?

APlastic surgeons commonly see people who have diabetes. Diabetes is a disorder in which the body cannot take excessive sugar, specifically glucose, which is consumed when eating. Complications from diabetes can warrant reconstructive surgery.

Plastic surgeons are often called upon to monitor and treat slow-healing or non-healing wounds in diabetic patients. Additionally, some people with diabetes also look to have cosmetic plastic surgery to enhance their appearance. This presents a unique problem to the plastic surgeon.

All types of surgery create a wound or incision. Any time an incision is made on the skin, no matter how small it is, a scar will be created. This is the body’s normal response, known as healing. Plastic surgeons, for better or worse, have acquired a reputation for “scarless” surgery. This reputation has come about not because there are no scars that occur at the hands of plastic surgeons, but because plastic surgeons have more opportunity to hide scars in inconspicuous places on the body. These inconspicuous places include skin creases and areas that are covered by innerwear or a two-piece swimsuit. Plastic surgeons are concerned about how their incisions heal in all of their patients. While complications can arise even in a totally healthy patient, extra care must be taken in patients with diabetes as they may be more prone to issues related to wound healing.

A person with diabetes can undergo cosmetic plastic surgery if their blood glucose levels are under control. How is good control of blood glucose levels determined? Along with the usual battery of blood work that comes before having surgery, a vigilant plastic surgeon will ask for another specific blood test in their diabetic patients.This test is known as a glycosylated hemoglobin level, also known as hemoglobin A1c test. This test helps to assess the long-term control of blood glucose levels, specifically, how well the blood glucose levels have been controlled in the prior two to three months.

This level should be less than 7 per cent. If it is higher than 7 per cent, it is an indicator that over the past two to three months, the blood glucose levels have been too high and the person needs an adjustment in their insulin management.

Additionally, because surgery can affect how the body responds to insulin, it is prudent for a plastic surgeon to work with the doctor managing the patient’s diabetes. Diabetes medications may have to be adjusted in the immediate period after surgery.