Taraschi Federico, Salgarello Marzia
UOSD Chirurgia Plastica, Dipartimento per la Salute della Donna, del Bambino e di Sanità Pubblica - Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS - Università Cattolica del "Sacro Cuore", Largo A. Gemelli 8, 00168, Rome, Italy.
Aesthetic Plast Surg. 2025 Aug;49(15):4527-4530. doi: 10.1007/s00266-025-04703-4. Epub 2025 Jan 22.
Obesity is a growing global epidemic, with glucagon-like peptide-1 (GLP-1) receptor agonists emerging as effective pharmacological solutions for weight loss. However, these medications raise concerns in the context of aesthetic and reconstructive surgery due to their effects on wound healing, adipose tissue metabolism, and their potential impact on surgical outcomes.
To report two cases of delayed wound healing and fat necrosis in patients undergoing breast surgery while receiving GLP-1 receptor agonists for weight management.
In our private clinical practice, two patients were observed. Both underwent breast surgeries (implant exchange with mastopexy and reduction mammoplasty) while using GLP-1 agonists (liraglutide). One patient continued therapy perioperatively, while the other discontinued seven days prior to surgery.
Both patients experienced delayed wound healing. Wound dehiscence followed a characteristic progression involving fat necrosis and secondary healing. Despite standard surgical techniques and postoperative care, healing was prolonged in both cases.
These findings highlight the potential impact of GLP-1-induced rapid weight loss on surgical outcomes. Current guidelines recommend therapy suspension to avoid anesthetic complications, but further studies are needed to evaluate the necessity of preoperative discontinuation in terms of surgical outcomes.
Our cases highlight the risk of delayed wound healing, fat necrosis, and tissue fragility in patients undergoing breast surgery while receiving GLP-1 receptor agonists. These complications have not been previously described in the literature, making this report particularly relevant as an alert for clinicians.
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肥胖是一种在全球范围内日益严重的流行病，胰高血糖素样肽-1（GLP-1）受体激动剂已成为有效的减肥药物解决方案。然而，由于这些药物对伤口愈合、脂肪组织代谢的影响以及它们对手术结果的潜在影响，在美容整形手术中引起了关注。
报告两例在接受GLP-1受体激动剂进行体重管理的患者中，乳房手术出现伤口愈合延迟和脂肪坏死的病例。
在我们的私人临床实践中，观察了两名患者。两人在使用GLP-1激动剂（利拉鲁肽）的同时接受了乳房手术（植入物置换联合乳房上提术和乳房缩小成形术）。一名患者在围手术期继续治疗，而另一名患者在手术前七天停药。
两名患者均出现伤口愈合延迟。伤口裂开遵循了包括脂肪坏死和二期愈合的典型过程。尽管采用了标准的手术技术和术后护理，但两例患者的愈合均延长。
这些发现突出了GLP-1诱导的快速体重减轻对手术结果的潜在影响。目前的指南建议暂停治疗以避免麻醉并发症，但需要进一步研究以评估术前停药对手术结果的必要性。
我们的病例突出了接受GLP-1受体激动剂的患者在乳房手术中出现伤口愈合延迟、脂肪坏死和组织脆弱的风险。这些并发症此前在文献中尚未有描述，因此本报告作为对临床医生的警示尤为重要。
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