Post Weight Loss Body Contouring Surgery: Complication Rates Following Bariatric Surgery, Injectable Glucagon-like Peptide-1 Receptor Agonist Pharmacotherapy, Combination Therapy, and Lifestyle Modification

BACKGROUND: Because the demand for body-contouring surgery has increased following the widespread adoption of glucagon-like peptide-1 receptor agonists, the impact of different weight-loss methods on patient selection, operative techniques, and postoperative outcomes remains unclear. OBJECTIVES: This study compared complication rates across weight-loss modalities and identified predictors of adverse outcomes in body-contouring patients. METHODS: A single-center, retrospective, cohort study of patients who underwent post-weight-loss body-contouring surgery between January 2019 and December 2024 was performed. Eligible patients were adults who achieved weight loss and subsequently underwent panniculectomy, brachioplasty, thighplasty, or breast surgery. Patients were classified into 4 groups based on weight-loss modality: surgical, injectable GLP-1 pharmacotherapy, combination, or lifestyle. The primary outcome was the incidence of postoperative complications within 90 days for each procedure. RESULTS: Among 1002 post-weight-loss patients undergoing body contouring, weight-loss methods included surgery (67.9%), lifestyle (14.3%), GLP-1 pharmacotherapy (7.8%), and combination therapy (10.1%). Baseline characteristics differed significantly across groups. Across all procedures, complication rates did not differ by weight-loss modality. Panniculectomy, brachioplasty, thighplasty, and breast procedures demonstrated expected procedure-specific complication patterns, with higher BMI at the time of surgery and diabetes independently predicting increased risk. CONCLUSIONS: Weight-loss modality does not appear to impact the incidence of postoperative complications following body-contouring surgery. BMI at the time of surgery and diabetes are independent predictors of adverse outcomes. LEVEL OF EVIDENCE: 3 (Therapeutic) For image description, please refer to the figure legend and surrounding text.