Grants Funded

Abstract

Project Summary: Glucagon-like peptide-1 (GLP-1) receptor agonists represent a class of medications used for the treatment of diabetes mellitus type II. Recently, GLP-1 receptor agonist formularies, such as Semaglutide or Tirzepatide, were introduced to the market under the brand names Wegovy, Ozempic, or Mounjaro. In addition to improving diabetic markers in patients with diabetes mellitus type II, they have been shown to exert favorable effects on weight loss with patients reporting 10-20% weight loss over the course of six months of on- or off-label use. Although the exact mechanism resulting in weight loss is not completely understood, these medications have gained popularity quickly among interested patients. Following the use of GLP-1 receptor agonists for weight loss, many patients will eventually seek plastic surgery consultation for body contouring procedures to treat excess skin. Anecdotally it has been observed that the use of GLP-1 receptor agonists affects the skin and adipose tissue of the entire body and produces changes that resemble aging. Anesthesiologists have also raised concerns regarding use of these medications in patients undergoing surgery because of delayed gastric emptying which can lead to aspiration. Despite the popularity of the medications, there is a paucity of data regarding their safety in patients undergoing plastic surgery procedures. In this study, we seek to objectively describe the number of patients taking GLP-1 receptor agonists who undergo plastic surgery body contouring procedures and evaluate reported general and surgery-specific complications. Finally, we will assess costs related to their care and compare all outcomes to matched patients not taking GLP-1 receptor agonists. For the purposes of our study, we will assess our institutional database to identify eligible patients and review their data to explore the outcomes of interest. In addition, we will access national databases and perform similar analyses to understand these trends nationally. The long-term goal of this study is to better appreciate the outcomes of patients taking GLP-1 receptor agonists who undergo body contouring procedures and establish guidelines regarding dosage, frequency, and timing of administration of GLP-1 receptor agonists in the perioperative period. Clinically, we believe that this knowledge is important to understand the safety and the efficacy of performing plastic surgery procedures in this growing subset of patients.

Impact Statement: With the incredibly fast increase in the use of GLP-1 receptor agonists, plastic surgeons have been unable to objectively, and with scientific methods, assess the safety of these medications for their patients. Anecdotally, structural changes to skin and adipose tissue have been observed in patients taking GLP-1 receptor agonists who seek body contouring or rejuvenation procedures. These changes may potentially lead to poor wound healing, unfavorable scar formation or contour irregularities. We aim to objectively quantify the number of patients taking GLP-1 receptor agonists who undergo body contouring procedures at our institution and nationally and examine the complication rates, and cost of care associated with them.

Biography
Charalampos ‘Harry’ Siotos, MD, PhD is a physician resident at the integrated plastic surgery program at Rush University Medical Center (Chicago, IL). He completed his medical and doctoral degree at the National and Kapodistrian University of Athens, Greece. He subsequently completed a postdoctoral clinical research fellowship at the Department of Plastic and Reconstructive Surgery at Johns Hopkins University (Baltimore, MD), focusing on patient safety, evidence-based, and patient centered outcomes research. In his short career, he has published more than 60 peer-reviewed articles that have generated more than 700 citations and he has achieved an H-index of 18. During his residency alone, he has been awarded funding by professional organizations or societies of approximately $60,000 USD and multiple distinctions including the PSF Clinical Research Leaders Scholarship.