Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for glycemic control and weight management in patients with type 2 diabetes and obesity, and their use has become increasingly common among candidates for elective plastic surgery. As a result, plastic surgeons are frequently encountering patients receiving GLP-1 RA therapy in the setting of metabolic and inflammatory comorbidities that may influence perioperative risk. This focused review examines the existing literature on GLP-1 RAs and contextualizes their biologic effects with considerations relevant to elective plastic surgery. A review of studies identified through PubMed, MEDLINE, and ClinicalKey was performed, with emphasis on the effects of GLP-1 RAs on chronic inflammation, immune signaling, endothelial function, and tissue biology in populations with metabolic or inflammatory disease. Across preclinical and clinical studies, GLP-1 RAs have been associated with attenuation of chronic inflammatory signaling, including reductions in circulating inflammatory markers and modulation of immune cell activity. Clinical benefits have been reported in conditions frequently encountered in plastic surgery practice, such as metabolic syndrome, polycystic ovary syndrome, and inflammatory skin diseases; however, direct evidence evaluating postoperative outcomes in surgical populations remains limited. Rather than acting on the acute postoperative healing response, GLP-1 RAs primarily influence chronic metabolic and inflammatory disease states that contribute to surgical risk. Understanding these effects may assist plastic surgeons in the perioperative setting, as GLP-1 RA therapy becomes increasingly prevalent in elective practice.
Patel et al. (Fri,) studied this question.