I am a huge fan of intermittent fasting- it helps my patients lose weight and helps reduce insulin resistance.
While flipping through my May 2023 PRS Journal, I saw this journal article in the experimental section (it means studies done in the lab, not in practice yet). This was titled “Perioperative Intermittent Fasting Protects Ischemic Musculocutaneous Flap Tissue from Necrosis.” In English, this is saying that intermittent fasting helped flaps (which we use during facelift, breast lift and breast reduction, and tummy tuck surgeries) not have necrosis, which means dead tissue. That is amazing!
How?
The study states that intermittent fasting has previously been shown to protect tissue from ischemia (ischemia = not enough blood flow/oxygen) induced necrosis. So they made a study with mice using muscle-skin flaps and intermittent fasting to test it.
- 8 mice in each arm
- The intermittent fasting group could only eat 8 hours of the day (16 fasting/8 hours feeding). The rest could eat whenever.
- They started 7 days prior to surgery.
- They did fluorescence microscopy on days 1, 3, 5, 7 and 10 after surgery and quantitated angiogenesis, nutritive blood perfusion, and flap necrosis. After this, they then harvest the flap and looked at it under a microscope.
Findings?
The intermittent fasting group had more newly formed microvessels and density in the new flap. This was associated with significantly lower rate of tissue necrosis. On histology they found different inflammatory cell subtypes. They conclude, intermittent fasting prevents flap necrosis by maintaining nutritive tissue perfusion and suppressing ischemia induced inflammation.
My thoughts?
If something as simple as intermittent fasting can improve healing after flap surgery, which is all breast reductions, breast lifts, tummy tucks, and facelifts, this is an easy to implement thing which could have great benefits.
I am a strong believer in nutrition for healing- read my blogs on protein loading and the studies to learn more. And I like probiotics anytime my patients are getting antibiotics.
So what I am hearing is I should advocate intermittent fasting as well. This isn’t hard science yet- it is a study in the lab- but the results seem convincing. So if you can do it- (ie essentially just skip breakfast) for the week prior to surgery, while still maintaining good calories and protein intake, I think you should do it.