Diabetes does not rule out body contouring. What it does is raise the stakes on wound healing, which means the preparation matters more — and that preparation is measurable.
Many patients coming to body contouring after major weight loss have had type 2 diabetes that has improved or resolved with the weight loss. That is a genuinely good position to be operating from.
Why it matters for this surgery
Body contouring lifts large areas of skin whose edges heal on a reduced blood supply. Elevated blood glucose impairs wound healing, increases infection risk and affects the small vessels the skin edges depend on. The combination of a long incision and poor glucose control is the one most likely to produce a wound that opens.
| Risk | What it looks like |
|---|---|
| Wound infection | More common and slower to clear |
| Delayed healing | Weeks of dressings; a wider scar |
| Wound separation | Most often at the points of highest tension |
| Seroma | More likely where healing is slow. Seroma |
The number that matters
HbA1c — your average glucose over about three months — is what surgeons and anaesthetists look at, because it reflects control over time rather than on the day. Work with your GP or endocrinologist to get it to the best level achievable for you before surgery.
Where control is poor, the right answer is to postpone and improve it rather than proceed. A few months of better control before a hip-to-hip incision is a good trade.
Practical preparation
- Get current HbA1c and bloods and bring them to your consultation.
- Review medications with your GP or specialist, including what happens around fasting for an anaesthetic.
- Tell the anaesthetist everything, including any weight-loss medication, which is relevant to fasting.
- Nutrition. Protein, iron, B12 and vitamin D are commonly low after bariatric surgery, and healing depends on them.
- Nicotine. Complete abstinence from all nicotine for eight weeks before and after. Diabetes plus nicotine is the combination most likely to produce a wound problem. More here.
- Check your feet and skin for any existing infection before surgery.
On the day and afterwards
Glucose is monitored around the operation, and you will be given specific instructions about medication and fasting. Afterwards, the usual advice applies with more attention to wound review — Dr Kumar’s nurses see you at one week, six weeks, twelve weeks and through to twelve months, and would rather see you early than late if anything looks wrong.
Ring on 1300 267 726 about redness spreading from a wound, fever, or a wound that opens.
Does it affect Medicare?
No. The items turn on the functional consequences of the redundant skin and on weight stability, not on your other conditions. The criteria.
Worth noting that recurrent intertrigo is both more common and more troublesome in diabetes — and documented, treated intertrigo is exactly what item 30177 asks for.
Common questions
Will I be refused surgery? Not for having diabetes. Possibly for poor control, until it is improved.
My diabetes resolved after bariatric surgery. Does it still count? Mention it, and bring recent bloods. It is a favourable history.
Will healing take longer? It can. The timeline is the same; the margin is narrower.
Should I see my endocrinologist first? If you have one, yes — ideally a few months before you want surgery.
Next step
Bring a GP referral, recent HbA1c and bloods, and your full medication list. Dr Kumar consults at Westmead, Penrith and Orange. Call 1300 267 726. More about preparing for surgery, and background at My Weight Loss Journey.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
