AAPS 104th Annual Meeting

A Deep Plane Dive Into GLP-1 Receptor Agonists and Facelift Outcomes

Chris Amro, MD1, Rebecca Lisk, BS1, Carter J. Boyd, MD1, Thomas J. Sorenson, MD1, Nicholas Cuccolo, MD1, Nolan S. Karp, MD1, Daniel J. Ceradini, MD1

1 Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York, USA

BACKGROUND

Rising GLP-1 Use: GLP-1 receptor agonists are increasingly prescribed for diabetes and obesity, including in patients pursuing elective cosmetic procedures.

Perioperative Concern: These medications have raised questions about surgical safety, particularly related to gastric emptying, wound healing, and postoperative recovery. Data on postoperative outcomes in aesthetic facial surgery remain limited.

Study Rationale: This study evaluated whether preoperative GLP-1 receptor agonist use is associated with complications after facelift surgery in a large national cohort.

METHODS

Data was collected from Epic Cosmos, a large, aggregated electronic health record (EHR) database with data from over 1,900 hospitals and 45,000 clinics, encompassing over 300 million unique individuals.

Adults undergoing facelift (rhytidectomy) between 2014–2024 were identified using CPT codes; patients required ≥1 year of prior clinical history.

Preoperative GLP-1 receptor agonist use was defined as ≥6 months of therapy prior to surgery.

Primary outcomes included 90-day postoperative complications (infection, wound dehiscence, hematoma, seroma, thromboembolism) and 30-day healthcare utilization (readmission, ED visit).

Outcomes were further evaluated by duration of GLP-1 use and time since discontinuation prior to surgery to assess exposure-dependent effects.

RESULTS

Cohort characteristics

•A total of 23,081 facelift patients were identified, including 411 (1.8%) with preoperative GLP-1 use

•In the unmatched cohort, GLP-1 users had higher BMI and were more likely to have diabetes, hypertension, and prior bariatric surgery.

•After propensity score weighting, the cohort was well balanced, with 825 patients included in the weighted analysis.

CONCLUSIONS

•In this nationwide cohort, preoperative GLP-1 receptor agonist use was not associated with increased postoperative complications after facelift surgery.

•Longer duration of use was associated with higher odds of wound dehiscence and lower odds of thromboembolic events, while time since discontinuation was not associated with outcomes.

FUTURE DIRECTIONS

Future studies should evaluate the impact of GLP-1 dosing, adherence, and perioperative management, as well as incorporate prospective data and procedure-specific variables to better define risk stratification in facelift patients.

Limitations:

•Reliance on EHR data may result in incomplete or inaccurate capture of diagnoses, medications, and complications.

•Lack of operative details (e.g., technique, extent of dissection, surgeon factors) that may influence outcomes.

•Potential for missed postoperative events if patients sought care outside participating institutions.

AAPS 104th Annual Meeting

A Deep Plane Dive Into Glp-1 Receptor Agonists And Facelift Outcomes

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