Four-week semaglutide discontinuation before abdominoplasty reduces postoperative complications to control levels

The increasing use of GLP-1 receptor agonists like semaglutide for weight loss has led to more non-diabetic patients seeking body contouring procedures. However, concerns have emerged regarding potential postoperative complications, such as delayed gastric emptying and altered inflammatory responses, when these medications are continued until surgery. Current standard-of-care lacks standardized perioperative management protocols for patients on GLP-1 therapy, creating a critical gap in ensuring patient safety and optimal surgical outcomes in aesthetic procedures like lipoabdominoplasty.

This retrospective cohort study evaluated the impact of preoperative semaglutide discontinuation timing on short-term postoperative outcomes in 80 patients undergoing primary lipoabdominoplasty. Patients were divided into four groups: Group A (continued semaglutide until surgery), Group B (2-week discontinuation), Group C (4-week discontinuation), and Group D (semaglutide-naïve controls). All participants were rigorously matched for age, BMI, and surgical technique. Postoperative complications, including wound dehiscence, infection, and seroma formation, were assessed within a 30-day period.

Continued semaglutide use until surgery (Group A) resulted in the highest complication rate at 45%. A 2-week discontinuation period (Group B) showed a moderate improvement, with a 30% complication rate. However, a 4-week preoperative discontinuation (Group C) demonstrated a significant reduction in adverse outcomes, achieving a 10% complication rate, which was comparable to the semaglutide-naïve control group (Group D) also at 10%. Complications observed included wound dehiscence, infection, and seroma formation.

Gastrointestinal intolerance and prolonged drain duration were also notably more frequent in patients who continued semaglutide use. No reoperations or readmissions were reported across any of the study groups.