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A Second Look: Starting Weight Loss Glucagon-Like Peptide-1 Receptor Agonists After Body Contouring Surgery Does Not Increase Complication Risks
Paul Won, MD
1,
Matthew Q. Dao, BS2, Matthew R. Greives, MD, MS
1.
1Division of Plastic and Reconstructive Surgery, Department of Surgery, The University of Texas Health Science Center at McGovern Medical School, Houston, TX, USA,
2John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
PURPOSE: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for weight loss. Although concerns persist regarding preoperative use, their safety profile when initiated in the postoperative period remains unclear. This study evaluates whether early GLP-1 RA use after body contouring surgery is associated with increased complication rates.
METHODS: A retrospective cohort analysis was conducted using the TriNetX database. Patients who underwent body contouring procedures (mastopexy, lipectomy, panniculectomy, abdominoplasty, reduction mammaplasty, or mastectomy for gynecomastia) were identified. Patients who began GLP-1 RAs (semaglutide, liraglutide, or tirzepatide) within 30 days after surgery comprised the exposure cohort, while those without any prescriptions were in the control cohort. Propensity score matching (1:1) was performed for demographics, comorbidities, and procedure. Ninety-day outcomes included wound dehiscence, surgical site infection (SSI), hematoma, seroma, and a composite of complications. Risk ratios (RR) were calculated with significance set at p<0.05.
RESULTS: Among 57,258 patients, 845 received GLP-1 RAs and 56,413 did not. Following matched analysis, 842 patients remained in each cohort. The GLP-1 RA cohort had a mean age of 49.1 ± 12.4 years compared with 49.1 ± 14.5 years in controls, and mean BMI was similar (32.6 ± 6.6 vs 32.8 ± 6.4 kg/m²). Complication rates were similar between matched GLP-1 RA users and controls: wound dehiscence (RR 1.08, p=0.759), SSI (RR 1.10, p=0.730), hematoma (RR 1.46, p=0.196), seroma (RR 0.92, p=0.821), and composite complications (RR 1.31, p=0.169).
CONCLUSION: Postoperative initiation of weight-loss GLP-1 RAs was not associated with higher rates of complications in body contouring surgery.
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