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What should we tell body contouring patients of different BMI status about GLP-1s: A national propensity-matched analysis
Sophia Ahn
*1, Michael J. Kuharski
1, Sanjana Challa
2, Amy Maselli
1, Reena Bhatt
11Brown University, Rumford, RI; 2Beth Israel Deaconess Medical Center, Boston, MA
BackgroundWhile studies suggest that glucagon-like peptide-1 agonists (GLP-1s) confer higher risk of postoperative complications, they are often prescribed in body contouring (BC) candidates. Nonetheless, it is unclear whether perioperative BMI impacts these disparities. This study sought to determine 1) whether GLP-1s increase risk of acute and long-term adverse events following abdominal BC and 2) if perioperative BMI affects differences in complication rates.
MethodsWe identified patients in TriNetX who underwent abdominal BC (abdominoplasty, panniculectomy)
+ preoperative GLP-1 prescriptions. We compared GLP-1 users vs. non-users, and users vs. non-users who both had elevated BMI (
> 30) at surgery. Propensity-score matching controlled for demographics and comorbidities (diabetes, other risk factors). Acute outcomes were measured if they occurred within 6 months of surgery and long-term outcomes, if they occurred within 5 years.
ResultsAfter matching, each cohort contained 2953 patients for acute outcomes and 2964 for long-term outcomes (with added relevant matching factors). Within 3 months, GLP-1 users demonstrated clinically modest, but significantly higher rates of seroma (
p = 0.0154), hematoma (p = 0.0215). Within 5 years, they sustained lower rates of abdominal wall hernia (p = 0.0287) and secondary surgery (p = 0.0287), compared to non-users. Comparing GLP-1 using and non-using BC patients of elevated BMI (N=601 matched pairs), there were no significant differences in terms of acute complications. But within 5 years, non-users of elevated BMI showed significantly higher rates of secondary surgeries (p = 0.0392) and hypertrophic or keloid scarring (p = 0.0305), as compared to GLP-1 users of elevated BMI.
ConclusionsAlthough GLP-1s may impact certain complications following abdominal BC, these differences change depending on BMI. Thus, risks may be at least partially attributable to perioperative BMI as opposed to independent GLP-1 usage. Research is warranted on whether other added relevant factors (i.e., malnutrition) may impact postsurgical complications.
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