Impact of Preoperative Semaglutide Discontinuation Timing on Postoperative Outcomes in Aesthetic Abdominoplasty: A Retrospective Comparative Study.
This retrospective cohort study examined how the timing of preoperative semaglutide discontinuation affects short-term surgical outcomes in patients undergoing aesthetic lipoabdominoplasty. Eighty non-diabetic patients were divided into four groups: those who continued semaglutide until the day of surgery (Group A), those who discontinued 2 weeks prior (Group B), those who discontinued 4 weeks prior (Group C), and semaglutide-naïve controls (Group D). Groups were matched for age, BMI, and surgical technique, and 30-day postoperative complications were tracked. The study found that Group A had the highest complication rate at 45%, encompassing wound dehiscence, infection, and seroma formation. Group B showed a moderate reduction (30%), while Group C's complication rate (10%) was comparable to the control group (10%). Gastrointestinal intolerance and prolonged drain duration were also more common among patients with recent or ongoing semaglutide use. No reoperations or readmissions were recorded. The authors concluded that a 4-week preoperative discontinuation window effectively normalizes complication rates. Key limitations include the retrospective design, small sample size (n=80 across four groups), and the absence of randomization, blinding, or long-term follow-up.
Why this grade: The study involves human patients but relies on a retrospective, non-randomized design with a small sample size (n=80), which substantially limits causal inference and generalizability.
The widespread adoption of GLP-1 receptor agonists such as semaglutide for weight loss has led to an increasing number of non-diabetic patients seeking body contouring procedures after pharmacologic weight reduction. However, concerns have emerged regarding postoperative complications potentially linked to GLP-1 therapy, particularly when continued up to the time of surgery. This retrospective cohort study aimed to evaluate the impact of preoperative semaglutide discontinuation timing on short-term postoperative outcomes in aesthetic lipoabdominoplasty. Eighty patients who underwent primary lipoabdominoplasty were divided into four groups: continued semaglutide until surgery (Group A), 2-week discontinuation (Group B), 4-week discontinuation (Group C), and semaglutide-naïve controls (Group D). All patients were matched for age, BMI, and surgical technique. Postoperative complications within 30 days were assessed. Group A exhibited the highest complication rate (45%), including wound dehiscence, infection, and seroma formation. Group B showed moderate improvement (30% complication rate), while Group C demonstrated a significant reduction in adverse outcomes (10%), comparable to the control group (10%). Gastrointestinal intolerance and prolonged drain duration were also more frequent in patients with ongoing semaglutide use. No reoperations or readmissions occurred. Continuation of semaglutide until surgery significantly increases postoperative complication risk in lipoabdominoplasty. A 4-week preoperative discontinuation period effectively normalizes outcomes, supporting its use as a safety measure in aesthetic surgery candidates. These findings emphasize the need for standardized perioperative management protocols for patients on GLP-1 therapy and underscore the importance of interdisciplinary coordination and nutritional assessment. 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 .
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