GLP-1 Receptor Agonists increase wound complications and sarcopenia risks in aesthetic surgery patients.

The increasing use of GLP-1 receptor agonists (GLP-1 RAs) for weight management has introduced a new patient population seeking aesthetic and body contouring surgery. Unlike traditional massive weight loss (MWL) achieved through bariatric surgery, GLP-1 RA-induced weight loss can be rapid, potentially leading to distinct perioperative challenges and altered body composition. Current standard-of-care protocols for aesthetic surgery, particularly fasting guidelines and body contouring strategies, may not adequately address the unique physiological effects of GLP-1 RAs, such as delayed gastric emptying and potential lean mass reduction, creating a critical gap in surgical planning and patient safety.

This study conducted a targeted narrative review of existing literature to synthesize information on perioperative safety, body composition changes, and aesthetic/body contouring outcomes specifically relevant to GLP-1 RA users. The authors integrated classical massive weight-loss (MWL) body contouring principles with emerging evidence to develop a practical conceptual framework. This framework aims to guide surgeons in perioperative assessment and surgical planning for patients undergoing aesthetic procedures after GLP-1 RA-induced weight loss, addressing the unique challenges posed by these medications.

Emerging evidence from aesthetic/body contouring cohorts indicates higher wound complication rates in GLP-1 RA users. Specifically, semaglutide users experienced increased wound dehiscence at a rate of 5.19% compared to 2.78% in matched controls. Perioperative data from mixed surgical populations suggest that some GLP-1 RA users may retain gastric contents despite standard fasting protocols, necessitating individualized risk assessment. This finding supports the need for symptom screening and multidisciplinary planning to mitigate aspiration risks. Furthermore, weight loss associated with GLP-1 RAs may coincide with clinically relevant reductions in lean muscle mass. This sarcopenic morphology can significantly influence tissue quality and, consequently, the optimal body contouring strategy, requiring surgeons to adapt their approaches. The review highlights that while these trends are concerning, prospective aesthetic-specific data remain limited. > The most significant finding indicates that semaglutide users face nearly double the rate of wound dehiscence (5.19% vs 2.78%) compared to controls in aesthetic surgery cohorts.