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Glucagon-Like Peptide-1 Agonists: A Practical Overview for Plastic and Reconstructive Surgeons
Eloise W Stanton, Artur Manasyan1, Rakhi Banerjee1
1From the Keck School of Medicine, University of Southern California, Los Angeles, CA.
Annals of Plastic Surgery
|September 18, 2024
Summary
Glucagon-like peptide-1 (GLP-1) agonists aid weight loss and glycemic control, potentially benefiting plastic surgery patients. Careful consideration of risks like aspiration is crucial for safe integration into perioperative care.
Area of Science:
- Endocrinology and Metabolism
- Plastic Surgery
- Pharmacology
Background:
- Glucagon-like peptide-1 (GLP-1) agonists are established treatments for type 2 diabetes, offering benefits in insulin release, glucagon suppression, and glucose metabolism.
- These agents also promote weight reduction and improve cardiovascular health, suggesting broader therapeutic applications.
- Their potential role in perioperative weight management and glycemic control presents opportunities within plastic surgery.
Purpose of the Study:
- To review the utilization of GLP-1 agonists in plastic surgery.
- To evaluate their benefits and limitations in perioperative weight management and glycemic control.
- To assess their impact on surgical candidacy and outcomes.
Main Methods:
- Comprehensive literature review of relevant studies, meta-analyses, and clinical trials.
- Analysis focused on weight reduction, glycemic control, cardiovascular risk factors, and potential complications.
- Evaluation of GLP-1 agonists' efficacy and safety in surgical contexts.
Main Results:
- GLP-1 agonists demonstrate efficacy in weight management and glycemic control, with significant HbA1c reductions observed with high-dose semaglutide and tirzepatide.
- Potential benefits include expanded surgical candidacy and improved outcomes for procedures like breast reconstruction and lymphedema management.
- Concerns include gastrointestinal side effects, pancreatitis, bowel obstruction, venous thromboembolism, and delayed gastric emptying, necessitating careful risk assessment.
Conclusions:
- GLP-1 agonists offer advantages for perioperative weight management and glycemic control in plastic surgery.
- They may enhance surgical candidacy and mitigate lymphedema risk but require careful management of complications, especially aspiration risk.
- Further research is needed to optimize their integration into plastic surgery protocols and enhance patient care.
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