Prospective Comparative Analysis of Synchronous Abdominoplasty and Mastopexy in Bariatric and Nonbariatric Massive Weight Loss Patients

ABSTRACT: Skin redundancy after massive weight loss often requires body contouring procedures such as abdominoplasty and mastopexy. Bariatric patients may face higher complication risks due to nutritional deficiencies. However, with proper management, including stable body weight and adequate nutritional status, these risks may be mitigated. In addition, glucagon-like peptide-1 (GLP-1) receptor agonists have recently emerged as a rising trend for nonbariatric weight loss, but their impact on surgical outcomes remains underexplored. Between January 2015 and August 2025, 101 consecutive weight-loss patients undergoing synchronous full abdominoplasty and mastopexy with a superomedial pedicle were prospectively enrolled. Forty-nine patients had undergone bariatric surgery, whereas 52 achieved weight loss without bariatric surgery, including 14 patients using GLP-1 receptor agonists (liraglutide or tirzepatide). Demographic characteristics, weight loss parameters, serum albumin levels, operative details, and complications (classified by Clavien-Dindo) were recorded. There were no significant differences between groups in age or BMI. The bariatric group demonstrated significantly greater absolute and percentage weight loss, although serum albumin levels were slightly lower compared to nonbariatric patients. The overall complication rate was 8.9%, with no life-threatening events (Clavien-Dindo grades IV and V). Complication rates did not differ significantly between bariatric and nonbariatric patients. Notably, no complications occurred in patients who lost weight with GLP-1 analogs. In conclusion, synchronous abdominoplasty and mastopexy can be performed safely in bariatric patients who maintain stable body weight for at least 6 months and have serum albumin level of >3.5 g/dL. The increasing use of GLP-1 analogs in nonbariatric weight-loss patients represents an important emerging trend that warrants further investigation in the context of body contouring surgery.