The answer changes with the operation, and for two of the four studied the risk went up. In implant-based reconstruction, GLP-1 users had higher odds of implant failure, at 1.70 (95% CI 1.18 to 2.45) [3]. After breast reduction, wound complications ran at 2.6% against 1.3% [4]. Free-flap reconstruction showed fewer complications, 9.0% against 17.1% [2]. Breast cancer surgery showed no significant difference, on 209 exposed patients [1].
Implant-based reconstruction
A records study identified 57,987 reconstruction patients between 2014 and 2024, of whom 823 had used a GLP-1 before surgery [3]. After matching on body mass index, comorbidities and timing, 326 implant patients were compared with controls. The odds of implant failure were 1.70 (95% CI 1.18 to 2.45). Wound-healing complications came in at an odds ratio of 1.90. Readmission or an emergency visit was 1.80 (95% CI 1.04 to 3.21).
Hematoma, seroma and blood clots did not differ. In the same study, 51 matched patients having autologous reconstruction showed no increased risk. That is a small group, and it cannot rule out a moderate difference. The pattern of one operation faring worse than another echoes the evidence across four other procedures.
Free-flap reconstruction
A second records study looked only at free-flap reconstruction from 2012 to 2025 [2]. Anyone with a GLP-1 prescription in the year before surgery counted as a user. After matching, composite wound complications were 9.0% in users and 17.1% in non-users. Surgical site infection was 4.1% against 8.1%, and wound dehiscence 3.8% against 7.8%.
The favorable result came from people without diabetes, at 7.9% against 18.6%. In people with diabetes, overall complication rates were comparable. The abstract does not give the size of either cohort.
Breast reduction
A third study excluded diabetes, cancer history and smoking, then matched GLP-1 users to non-users having breast reduction, abdominoplasty or panniculectomy [4]. Wound infection, breakdown or dehiscence within 30 days ran at 2.6% against 1.3% after breast reduction. Both abdominal procedures showed higher rates too. The absolute gap after breast reduction is about one extra complication per 77 operations.
Breast cancer surgery
The fourth study covered 750 patients at one tertiary center between January 2024 and August 2025 [1]. Of those, 209 had GLP-1 use in the 30 days before surgery, verified against pharmacy records. After adjustment, surgical site infection had an odds ratio of 1.28 (95% CI 0.81 to 2.03). Seroma was 1.22 (95% CI 0.83 to 1.79). Flap necrosis of grade II or worse was 1.41 (95% CI 0.83 to 2.40).
The exposed patients also had higher body mass index and more diabetes before surgery. The authors adjusted and weighted for that. Measured differences can be corrected; unmeasured ones cannot. The same limit runs through the spinal fusion databases.
What none of these measured
Anesthetists ask about these drugs for a different reason: slowed stomach emptying and the risk of inhaling stomach contents at induction. None of the four studies measured that. The digestive side of the question is covered in the gastroparesis guide.
The practical step does not depend on which way these results settle. Tell the surgical and anesthetic team you are taking one, and ask whether to pause it. That timing is their decision. Specialist guidance on what proper care around these drugs looks like is summarized in what a GLP-1 provider should do.