For\u00a0patients undergoing\u00a0body contouring surgery to remove excess abdominal skin after massive weight loss,\u00a0use of\u00a0GLP-1 weight-loss medications\u00a0may have\u00a0mixed effects on complication risks,\u00a0suggests a study in the\u00a0April\u00a0issue\u00a0of\u00a0Plastic and Reconstructive Surgery\u00ae,\u00a0the official medical journal of the\u00a0American Society of Plastic Surgeons\u00a0(ASPS). The journal is published in the Lippincott portfolio by\u00a0Wolters Kluwer.<\/p>\n
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.”<\/p>\n
Zachary Andrew Koenig, MD, lead author, West Virginia University School of Medicine, Morgantown<\/p>\n
Do GLP-1 medications affect body contouring risks?<\/p>\n
Body contouring\u00a0describes\u00a0a range of surgical procedures to remove excess skin and soft tissue in patients with major weight loss.\u00a0Panniculectomy\u00a0is\u00a0a\u00a0procedure\u00a0to\u00a0address\u00a0loose,\u00a0hanging skin and fat\u00a0(pannus)\u00a0from the lower abdomen.<\/p>\n
Plastic surgeons are seeing a\u00a0surge in the\u00a0number of patients taking\u00a0GLP-1 medications\u00a0for weight loss\u00a0and\/or\u00a0treatment of type 2 diabetes.\u00a0Plastic surgeons\u00a0may\u00a0prescribe GLP-1\u00a0drugs\u00a0themselves\u00a0\u2013 for example, to help\u00a0optimize\u00a0patient’s body weight before\u00a0body contouring surgery.<\/p>\n
Previous\u00a0studies have suggested\u00a0possible effects\u00a0of GLP-1 medications\u00a0on wound healing. These concerns are especially relevant for patients undergoing panniculectomy,\u00a0many of whom are already taking or are candidates for\u00a0GLP-1\u00a0treatment.<\/p>\n
Dr. Koenig and colleagues analyzed the outcomes of 373 patients undergoing panniculectomy at their medical center from 2013 to 2023. Of these, 21.7% of patients were taking GLP-1\u00a0medications\u00a0before surgery \u2013 a rate that increased sharply\u00a0in recent years.\u00a0To\u00a0isolate\u00a0the effects\u00a0of\u00a0GLP-1 drugs, the study excluded patients undergoing bariatric or hernia surgery.<\/p>\n
Differences in characteristics and complications for GLP-1 users<\/p>\n
On analysis of patient characteristics,\u00a0those\u00a0taking GLP-1 medications\u00a0were more likely to have\u00a0type 2 diabetes, high blood pressure, and chronic obstructive pulmonary disease.\u00a0However,\u00a0body\u00a0mass index was\u00a0not significantly different\u00a0between groups.<\/p>\n
Patients using GLP-1 medications were at higher\u00a0risk of delayed wound healing: 18.5%, compared to 7.5% in the non-GLP-1 group.\u00a0In contrast, GLP-1\u00a0users\u00a0had a lower rate of\u00a0seroma, or\u00a0fluid build-up under the wound: 4.9% versus 14.0%.\u00a0Both differences remained significant after adjustment\u00a0for\u00a0other factors.\u00a0Other complications \u2013 including\u00a0reopening of the surgical wound (dehiscence),\u00a0infection, and rehospitalization rate\u00a0\u2013\u00a0were\u00a0similar between groups.<\/p>\n
The\u00a0study\u00a0suggests\u00a0a “complex and nuanced interplay” between GLP-1 treatment and\u00a0healing\u00a0after panniculectomy.\u00a0The findings\u00a0“reinforce that while GLP1ra appear broadly safe perioperatively, their impact on soft tissue healing\u2026may involve unique mechanisms not yet fully understood,”\u00a0Dr. Koenig and colleagues write.\u00a0They note that their study\u00a0represents\u00a0a unique patient population, as West Virginia has the highest rate of GLP-1 prescriptions nationwide.<\/p>\n
“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,”\u00a0Dr. Koenig and coauthors conclude.\u00a0Within its limitations, the study\u00a0“provides valuable data on a rapidly evolving clinical landscape.”\u00a0The researchers emphasize the need for ongoing research, including\u00a0formal guidelines\u00a0related to GLP-1 medications and plastic surgery.<\/p>\n
Source:<\/p>\n
Journal reference:<\/p>\n