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Background <p>The rapid adoption of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for weight management has created new considerations for plastic surgeons, particularly regarding their impact on wound healing and perioperative outcomes. Patients presenting for body contouring procedures increasingly use GLP-1 RAs, yet the safety of these agents in surgical populations remains unclear.</p> Methods <p>We conducted the first systematic review and meta-analysis in accordance with Cochrane’s Handbook and PRISMA reporting guidelines comparing adults undergoing body-contouring procedures with and without GLP-1 RA exposure. Primary outcomes were surgical site occurrences (SSOs), including wound dehiscence, surgical site infection (SSI), seroma, and hematoma. Secondary outcomes included readmission, emergency visits, and gastrointestinal complications. Risk of bias was assessed using ROBINS-I, and pooled risk ratios (RRs) were calculated with random-effects models. Sensitivity was evaluated with leave-one-out (LOO) analyses.</p> Results <p>From 1,479 screened records, four studies (three retrospective, one prospective) comprising 8,944 patients were included. Semaglutide was the most frequently reported agent, accounting for more than 99% of prescriptions. Meta-analysis demonstrated a significantly higher risk of wound dehiscence among GLP-1 RA users (5.2% vs. 2.9%; RR 1.62; 95% CI 1.09–2.42; <i>p</i> = 0.017; I²=0%). No significant differences were observed for seroma (9.2% vs. 12.3%; RR 0.78; 95% CI 0.30–2.05; <i>p</i> = 0.613; I2 = 62.7%), hematoma (4.6% vs. 2.6%; RR 1.74; 95% CI 0.72–4.24; <i>p</i> = 0.220; I² = 0%), or surgical site infections (5.3% vs. 3.3%; RR 1.16; 95% CI 0.48–2.77; <i>p</i> = 0.746; I² = 65.6%). Composite surgical site occurrences analysis also showed no significant difference (13.9% vs. 9.2%; RR 1.31; 95% CI 0.90–1.90; <i>p</i> = 0.164; I² = 80.7%) with high heterogeneity (I²=80.7%). Leave-one-out sensitivity analysis revealed attenuation of the wound dehiscence association to non-significance (RR 1.02; 95% CI 0.46–2.26), while surgical site occurrences estimates were consistently non-significant, but heterogeneity remained high. ROBINS-I assessment rated all studies at moderate or serious risk of bias.</p> Conclusions <p>GLP-1 RA use in body contouring surgery may be associated with an increased risk of wound dehiscence, although this finding appears largely driven by a single large cohort study. Other perioperative complications were not consistently elevated, but substantial heterogeneity and limited evidence reduce certainty. Further prospective studies are needed to guide perioperative management in this expanding patient population.</p>

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Safety of GLP-1 receptor agonists in body contouring surgery: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月4日

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  • Bernardo G. Collaco,
  • Cesar A. Gomez-Cabello,
  • Syed Ali Haider,
  • Ariana Genovese,
  • Srinivasagam Prabha,
  • Brian D. Rinker,
  • Antonio Jorge Forte,
  • Adekunle I. Elegbede

摘要

Background

The rapid adoption of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for weight management has created new considerations for plastic surgeons, particularly regarding their impact on wound healing and perioperative outcomes. Patients presenting for body contouring procedures increasingly use GLP-1 RAs, yet the safety of these agents in surgical populations remains unclear.

Methods

We conducted the first systematic review and meta-analysis in accordance with Cochrane’s Handbook and PRISMA reporting guidelines comparing adults undergoing body-contouring procedures with and without GLP-1 RA exposure. Primary outcomes were surgical site occurrences (SSOs), including wound dehiscence, surgical site infection (SSI), seroma, and hematoma. Secondary outcomes included readmission, emergency visits, and gastrointestinal complications. Risk of bias was assessed using ROBINS-I, and pooled risk ratios (RRs) were calculated with random-effects models. Sensitivity was evaluated with leave-one-out (LOO) analyses.

Results

From 1,479 screened records, four studies (three retrospective, one prospective) comprising 8,944 patients were included. Semaglutide was the most frequently reported agent, accounting for more than 99% of prescriptions. Meta-analysis demonstrated a significantly higher risk of wound dehiscence among GLP-1 RA users (5.2% vs. 2.9%; RR 1.62; 95% CI 1.09–2.42; p = 0.017; I²=0%). No significant differences were observed for seroma (9.2% vs. 12.3%; RR 0.78; 95% CI 0.30–2.05; p = 0.613; I2 = 62.7%), hematoma (4.6% vs. 2.6%; RR 1.74; 95% CI 0.72–4.24; p = 0.220; I² = 0%), or surgical site infections (5.3% vs. 3.3%; RR 1.16; 95% CI 0.48–2.77; p = 0.746; I² = 65.6%). Composite surgical site occurrences analysis also showed no significant difference (13.9% vs. 9.2%; RR 1.31; 95% CI 0.90–1.90; p = 0.164; I² = 80.7%) with high heterogeneity (I²=80.7%). Leave-one-out sensitivity analysis revealed attenuation of the wound dehiscence association to non-significance (RR 1.02; 95% CI 0.46–2.26), while surgical site occurrences estimates were consistently non-significant, but heterogeneity remained high. ROBINS-I assessment rated all studies at moderate or serious risk of bias.

Conclusions

GLP-1 RA use in body contouring surgery may be associated with an increased risk of wound dehiscence, although this finding appears largely driven by a single large cohort study. Other perioperative complications were not consistently elevated, but substantial heterogeneity and limited evidence reduce certainty. Further prospective studies are needed to guide perioperative management in this expanding patient population.