GLP-1 Agonists in Plastic Surgery: Impact on Aesthetic Outcomes-Two Case Reports.

Abstract

Background: Obesity is a growing global epidemic, with glucagon-like peptide-1 (GLP-1) receptor agonists emerging as effective pharmacological solutions for weight loss. However, these medications raise concerns in the context of aesthetic and reconstructive surgery due to their effects on wound healing, adipose tissue metabolism, and their potential impact on surgical outcomes.

Objective: To report two cases of delayed wound healing and fat necrosis in patients undergoing breast surgery while receiving GLP-1 receptor agonists for weight management.

Materials and methods: In our private clinical practice, two patients were observed. Both underwent breast surgeries (implant exchange with mastopexy and reduction mammoplasty) while using GLP-1 agonists (liraglutide). One patient continued therapy perioperatively, while the other discontinued seven days prior to surgery.

Results: Both patients experienced delayed wound healing. Wound dehiscence followed a characteristic progression involving fat necrosis and secondary healing. Despite standard surgical techniques and postoperative care, healing was prolonged in both cases.

Discussion: These findings highlight the potential impact of GLP-1-induced rapid weight loss on surgical outcomes. Current guidelines recommend therapy suspension to avoid anesthetic complications, but further studies are needed to evaluate the necessity of preoperative discontinuation in terms of surgical outcomes.

Conclusion: Our cases highlight the risk of delayed wound healing, fat necrosis, and tissue fragility in patients undergoing breast surgery while receiving GLP-1 receptor agonists. These complications have not been previously described in the literature, making this report particularly relevant as an alert for clinicians.

Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .