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Duke's Ash Patel links rapid weight loss to surgery risks
The researchers found that patients who combined bariatric surgery with GLP-1 medications experienced the highest complication rates.
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Pranavi Sharma - Tue, 14, Jul 2026
- 03:29 EDT
- 20
Ash Patel / Duke School of Medicine
Indian-origin plastic and reconstructive surgeon Ash Patel has co-authored a Duke University School of Medicine study that found rapid, significant weight loss before body contouring surgery is associated with higher rates of surgical complications and repeat operations.
The study, published in the journal Plastic and Reconstructive Surgery, analyzed more than a decade of abdominal body contouring procedures, including tummy tucks, performed on more than 500 patients. Researchers examined whether the amount and speed of weight loss affected outcomes after surgery to remove or tighten excess skin following major weight loss.
Patients were grouped based on how they lost weight: bariatric surgery alone, GLP-1 medications such as semaglutide and tirzepatide alone, or a combination of bariatric surgery and GLP-1 drugs.
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The researchers found that patients who combined bariatric surgery with GLP-1 medications experienced the highest complication rates. This group lost about 29 percent of their body weight, compared with about 10 percent among patients who used GLP-1 medications alone, and also lost weight at the fastest rate.
According to the study, patients who underwent both bariatric surgery and GLP-1 therapy were significantly more likely to develop seromas, pockets of fluid that can form beneath the skin after surgery, and hematomas, collections of blood that require medical attention. They were also more likely to require additional surgery.
Nearly 29.6 percent of patients who received both bariatric surgery and GLP-1 therapy returned to the operating room, compared with 5.1 percent of patients who had not undergone medical weight-loss treatment.
The findings suggest that both the amount of weight lost and the speed at which it is lost may influence healing after body contouring procedures. Researchers said slower, sustained weight loss may allow the body and skin more time to adapt, while rapid weight loss may affect tissue quality and recovery.
The study also examined the timing of surgery. Most patients who underwent bariatric surgery sought body contouring about two years later. Patients in the GLP-1 group stopped taking the medications about 10 weeks before plastic surgery after using them for an average of 103 weeks.
The study recommends that patients considering body contouring after substantial weight loss discuss surgical timing, expectations and potential risks with their healthcare teams, particularly if they have used more than one weight-loss method.
Researchers also noted that nutritional optimization is an important part of preparation for surgery. Patients who undergo major weight loss can develop deficiencies in vitamins A, D, E, K and B12, as well as folate, copper and iron, all of which play important roles in wound healing.
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