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The Hidden Cost of Weight Loss: GLP-1 Receptor Agonists Double Complication Rates in Implant-Based Breast Reconstruction (IBBR)
Aamirah Mccutchen
*, Margaret M. Hornick, Timothy C. Olsen, Ayaka N. Deguchi, Robyn B. Broach, Joseph Serletti
Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
BackgroundObesity and metabolic disease are increasingly prevalent in breast cancer populations. Glucagon-like-peptide-1 (GLP-1) receptor agonists, while effective for weight reduction, cause gastrointestinal side effects that compromise nutritional status and wound healing. However, large-scale evidence examining GLP-1 use within implant-based breast reconstruction (IBBR), a common reconstructive approach, remains limited. This study examines the association between GLP-1 use and postoperative complications following IBBR to inform clinical decision making.
MethodsThis study utilized a global database to identify women who underwent IBBR from January 2019 to January 2026. Patients were stratified into two cohorts: GLP-1 use within 270 days before surgery and non-users. Primary outcomes were assessed at 90 days postoperatively. Propensity score matching (1:1) was performed on age, race, and tobacco use. Subgroup analyses examined diabetic patients and obese patients (BMI 30-39 kg/m2).
ResultsAmong 20,672 patients, 495 GLP-1 users and 20,177 non-users were identified. GLP-1 users were older (53.6 vs. 50.7 years), exhibited higher mean BMI (32.6 vs. 28.0 kg/m2), and greater diabetes prevalence (50.9% vs. 6.9%). After matching (495 pairs), GLP-1 users experienced significantly higher rates of seroma (5.7% vs. 2.4%, p=0.009), hematoma (8.9% vs. 5.1%, p=0.017), skin and subcutaneous tissue complications (6.1% vs. 2.6%, p=0.008) and wound dehiscence (7.1% vs. 4.0%, p=0.037). Diabetic GLP-1 users were at increased risk of wound dehiscence (7.4% vs. 3.5%, p=0.042). Obese GLP-1 users demonstrated elevated wound complications (13.2% vs. 8.6%, p=0.126).
ConclusionGLP-1 agonist use is associated with significantly increased postoperative complications following IBBR. The increased complication rates observed in obese GLP-1 users represent a clinically important trend given the large number of obese patients using these medications. As GLP-1 use continues to surge, these findings have critical implications for perioperative counseling, risk stratification, and surgical planning.
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
Back to 2026 Abstracts
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
