New Contours, Different Risks: A 9-Year Comparison of Trends and Postoperative Complications in Patients Undergoing Aesthetic Surgery With Previous Bariatric Surgery Vs Glucagon-Like Peptide 1 Receptor Agonist Use
Jeffrey Khong, Rachana Suresh, Kitae E. Park, Hooman Soltanian
Abstract
BACKGROUND: The significant weight loss associated with bariatric surgery and glucagon-like peptide 1 receptor agonist (GLP-1 RA) use often prompts patients to seek aesthetic procedures to address changes in skin tightness and body contours. OBJECTIVES: The authors of this study sought to examine trends in aesthetic surgery utilization and postoperative complication rates between these 2 patient populations. METHODS: Using the TriNetX database, the authors identified patients undergoing aesthetic procedures between 2016 and 2024 and stratified cohorts based on previous bariatric surgery or GLP-1 RA use. Mean annual growth rates between groups were compared using least-squares means with post hoc Tukey tests. Postoperative 90-day complication rates, including hematoma, seroma, infection, wound dehiscence, deep vein thrombosis and pulmonary embolism, emergency department (ED) utilization, readmissions, and mortality, were evaluated using risk ratios (RRs) after propensity score matching. RESULTS: Between 2016 and 2021, the mean annual growth rate of aesthetic procedures among GLP-1 RA users was 36.1% per year, compared with 27.1% among postbariatric patients (P = .0026). After 2021, the mean annual growth rate aesthetic procedures increased to 53.8% (+17.7%, 95% CI, 10.4%-25.4%) for GLP-1 RA users and declined to -4% (-31.1%, 95% CI, -37.7% to -25.5%) for postbariatric surgery patients. After matching, bariatric surgery patients had higher risk of hematoma (RR: 1.99; CI, 1.10-3.62, P < .05), infections (RR: 1.37; CI, 1.01-1.88, P < .05), and ED use (RR: 1.54; CI, 1.05-2.26, P < .05). CONCLUSIONS: Aesthetic surgery utilization is sharply increasing among patients with previous GLP-1 RA use compared with postbariatric surgery patients. Postsurgical hematoma, infection, and ED utilization were greater in postbariatric patients. Future studies are needed to investigate underlying factors.