GLP-1 receptor agonist use and postoperative complications after body contouring surgery following massive weight loss

BACKGROUND: Patients who undergo body contouring surgery after massive weight loss are routinely optimised before surgery; however, the impact of preoperative glucagon-like peptide-1 receptor agonist (GLP-1 RA) exposure on postoperative outcomes remains uncertain. METHODS: We conducted a retrospective single-centre cohort study by including 282 adults who underwent body contouring surgery following massive weight loss at the Aalborg University Hospital, Denmark, between December 2022 and December 2025. Patients were categorised based on their weight-loss modality (lifestyle intervention, bariatric surgery, or GLP-1 RA treatment). Multivariable logistic regression adjusted for age, sex, body mass index, ASA class, diabetes mellitus, and procedure type was used to evaluate the association between GLP-1 RA exposure and postoperative complications. RESULTS: Compared with lifestyle-induced weight loss, GLP-1 RA exposure was found to be independently associated with increased odds of postoperative infection (OR 3.72, 95% CI 1.52-9.07; p=0.003) and wound dehiscence requiring intervention under general anaesthesia (OR 16.71, 95% CI 1.99-139.88; p=0.009), whereas no significant associations were observed for wound dehiscence requiring local anaesthesia or postoperative bleeding. Previous bariatric surgery was not associated with increased risk of any investigated complication. CONCLUSION: Despite standardised preoperative optimisation, preoperative GLP-1 RA exposure continued to be independently associated with postoperative infection and wound dehiscence requiring intervention under general anaesthesia. These findings indicate that conventional preoperative assessment may not fully capture surgical risk in patients undergoing body contouring surgery after massive weight loss.