Body-Contouring Surgery After GLP-1–Induced Massive Weight Loss: Surgical Outcomes, Complications, and Patient-Reported Quality of Life

Abstract

The rapid adoption of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has created a growing population presenting for body-contouring surgery after pharmacologically induced massive weight loss (MWL). Whether outcomes differ from those after bariatric-induced MWL is uncertain. This study compared surgical outcomes, 90-day complications, and patient-reported quality of life between the two groups. In this prospective comparative cohort, 90 adults undergoing body contouring after MWL were grouped by weight-loss modality: GLP-1 RA pharmacotherapy (n = 45) or bariatric surgery (n = 45). Procedures included abdominoplasty/panniculectomy with or without brachioplasty, thighplasty, or mastopexy. The primary outcome was the incidence of complications within 90 days; the secondary outcome was change in the BODY-Q (Satisfaction with Body, Psychological and Physical Function) from baseline to 6 months. Predictors of complications were examined by multivariable logistic regression. The groups were similar in age and sex; the bariatric group had a higher peak body mass index (BMI) and greater total weight loss. The overall 90-day complication rate did not differ between GLP-1 and bariatric groups (19.0% vs 22.2%; p = 0.69), nor did any individual complication. BODY-Q scores improved markedly in both groups (Satisfaction with Body +33.3 vs +36.3 points; both p < 0.001), with no significant between-group difference. On multivariable analysis, BMI at surgery (adjusted OR 1.78 per 5 kg/m²; p = 0.02) and current smoking (OR 2.40; p = 0.04) predicted complications, whereas weight-loss modality did not (OR 0.83; p = 0.69). Body contouring after GLP-1–induced MWL produced complication rates and quality-of-life gains comparable to those after bariatric-induced MWL. Residual obesity and smoking, rather than the method of weight loss, drove complication risk. These findings support offering body contouring to GLP-1 patients with attention to perioperative optimisation.