Use of GLP-1 weight-loss medications may have mixed effects on complication risks for patients undergoing body contouring surgery to remove excess abdominal skin, according to a study published in the April issue of Plastic and Reconstructive Surgery. The research was announced on Mar. 26 by the American Society of Plastic Surgeons.
The topic is important as more patients are taking GLP-1 drugs for weight loss or type 2 diabetes, and plastic surgeons may prescribe these medications to help optimize patient health before surgery. Understanding how these drugs influence surgical outcomes is critical as their use becomes more common.
Lead author Zachary Andrew Koenig, MD, from West Virginia University School of Medicine, said: "As GLP-1 receptor agonist [GLP1ra] medications become increasingly integrated into the care of patients undergoing body contouring, our findings suggest that these drugs may have subtle effects on wound healing, even if they don't increase overall surgical risks." Body contouring includes procedures such as panniculectomy to remove loose skin and fat from the lower abdomen after major weight loss.
The study analyzed outcomes for 373 patients who underwent panniculectomy between 2013 and 2023 at one medical center. Of those patients, about one in five were taking GLP-1 medications before surgery—a rate that has increased sharply in recent years. Patients using GLP-1 drugs were more likely to have conditions such as type 2 diabetes and high blood pressure but had similar body mass index compared with non-users.
Results showed that those taking GLP-1 medications had a higher risk of delayed wound healing (18.5% versus 7.5%) but a lower rate of seroma (fluid build-up) at 4.9% compared with 14% among non-users; other complications like infection or rehospitalization were similar between groups. Koenig and colleagues wrote that their findings highlight "a complex and nuanced interplay" between GLP-1 treatment and healing after panniculectomy: "while GLP1ra appear broadly safe perioperatively, their impact on soft tissue healing…may involve unique mechanisms not yet fully understood." They also noted West Virginia's high rate of GLP-1 prescriptions.
"Our findings suggest that while GLP1ra therapy does not appear to increase major surgical risk, it may affect specific aspects of healing that warrant proactive management," Koenig and coauthors concluded. They called for further research and formal guidelines regarding the use of these medications in plastic surgery.
