Effects of GLP-1 Receptor Agonists on Breast Reconstruction Outcomes: A Large-Database Retrospective Study

Area of Science:

• Plastic Surgery
• Endocrinology
• Patient Safety

Background:

• Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for diabetes and weight management.
• An increasing number of breast reconstruction patients are prescribed GLP-1RAs.
• Perioperative risks associated with GLP-1RA use in breast reconstruction are not well-defined.

Purpose of the Study:

• To investigate the association between GLP-1RA use and postoperative complications in patients undergoing breast reconstruction.
• To compare outcomes between implant-based and autologous tissue breast reconstruction in GLP-1RA users versus matched controls.

Main Methods:

• Retrospective analysis of TriNetX database from 2014-2024.
• Propensity score matching (1:1 and 1:3) of GLP-1RA users with controls based on demographics and comorbidities.
• Assessment of 90-day postoperative outcomes including implant failure, wound complications, and readmissions using logistic regression.

Main Results:

• GLP-1RA use was associated with significantly higher odds of implant failure (OR 1.70), wound healing complications (OR 1.90), and readmission/ED utilization (OR 1.80) in implant-based breast reconstruction.
• No significant differences in hematoma, seroma, or thromboembolism were noted for implant-based reconstruction.
• No increased postoperative risks were observed in patients undergoing autologous tissue breast reconstruction.

Conclusions:

• GLP-1RA use is linked to increased rates of implant failure, wound complications, and readmissions specifically in implant-based breast reconstruction.
• Patients on GLP-1RAs undergoing implant-based breast reconstruction require careful risk stratification and counseling.
• Further research is needed to understand the perioperative implications of GLP-1RAs in plastic surgery procedures.