GLP-1 Receptor Agonist-associated Weight Loss and Aesthetic Breast Surgery: A Narrative Review and Experience-based Recommendations for Plastic and Reconstructive Surgeons

Abstract The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for inducing weight loss has increased in recent years, resulting in a parallel reduction in demand for bariatric surgery. Consequently, the need for patients to undergo aesthetic procedures, including aesthetic breast surgery, following successful GLP-1 RA–induced weight loss is expected to increase while the demand created by postsurgical weight loss is expected to decrease. The objective of this narrative review is to examine the literature on the use of GLP-1 RAs and other mechanisms used for medical weight loss to assist plastic surgeons in achieving optimal aesthetic outcomes with breast surgery after weight loss occurs. To provide an overview of GLP-1 RAs in the context of aesthetic breast surgery, a PubMed literature search was performed using terms such as “glucagon-like peptide-1 receptor agonist,” “GLP-1,” and “breast.” Relevant studies in English published before December 6, 2024 were identified. Experience-based considerations from the authors (MN and AD) are provided to complement the currently available literature, and 2 case studies of patients who received aesthetic breast surgery following weight loss with GLP-1 RAs are presented. Because drastic changes in breast appearance may occur following weight loss treatment, including ptosis and asymmetry, surgeons should consider overall weight, body composition, and breast aesthetics and counsel patients prior to breast surgery. As our knowledge surrounding the effects of GLP-1 RA use expands, it is likely that surgical protocols and preoperative/postoperative patient counseling recommendations will need to be amended.