Scientific Abstract Presentations: Aesthetic Session 6 Friday, October 16 Fri, Oct 16 5:00-6:00 p.m. CDT

Goals/Purpose: Neck rejuvenation has evolved from superficial skin tightening to deeper structural modifications targeting the platysma, submental and subplatysmal fat, and submandibular glands. The surgical maneuvers necessary to achieve the ideal neck have long been debated. While many surgeons have achieved excellent results without addressing the submandibular glands, the evolution of social media has created a higher aesthetic standard. This increased scrutiny has inspired innovations in surgical techniques to deliver the ideal neck. Ben Talei's "mastoid crevasse" technique has led to more definition at the gonial angle, however optimizing the submandibular gland region remains challenging. Therefore, this study introduces the novel Hyoid-to-Mastoid Crevasse (HMC) neo-ligament technique, creating a neo-ligament from the hyoid to the mastoid bone for submandibular gland and optimal neck contouring in open neck lift surgery.

Methods: A retrospective cohort analysis was conducted at a single surgery center. All patients who underwent open dissection neck lift between January 2022 and July 2025 performed by a single- surgeon were included. Patients were categorized into two cohorts: the early cohort (January 2024-July 2025), treated with the traditional mastoid crevasse technique, and the recent cohort (January 2024-July 2025), treated with the HMC neo-ligament technique. Pre and postoperative cervicomental and gonial angles were measured and compared in all patients. Descriptive analyses were performed for demographics, operative characteristics, and outcomes. Paired t-tests were used for univariate comparisons, with statistical significance set at p<0.05.

Results: A total of 109 patients were included, 48 (%) in the early cohort and 61 (%) in the recent cohort. The average age of the early cohort was 60.47 years (range: 38 – 74), and in the recent cohort was 61.97 years (range: 41 – 79). The average BMI in the early cohort was 24.55 (range:18.1 - 35), and in the recent cohort 24.57 (range: 16.7 – 38.6). The average operative time was 219.73 minutes in the early cohort and 259.52 in the recent cohort. Overall complication rate was 27.8%, with 11 (23.4%) in the early cohort and 19 (31.1%) in the recent. Partial submandibular gland resection was performed in 24 patients (22.2%), all within the recent cohort. The average change in cervicomental angle in the early cohort was -15.99° (range: -71.82° to +19.6°) and - 20.71° (range: -70.14° to +17.01°) in the recent cohort. The average change in gonial angle - 2.41° (range: -92.37° to +30.69°) in the early cohort and -4.97° (range: -21.11° to +21.93°) in the recent cohort. In the early cohort, there was a difference between the preoperative and postoperative cervicomental angle (p<0.001). In the recent cohort, there was a difference between the preoperative and postoperative cervicomental and gonial angles (all p<0.001). No revision surgeries were performed. All complications resolved without sequelae.

Conclusion: Delivering the ideal neck is a cornerstone of facial and neck rejuvenation surgery. The cervicomental and gonial angles serve as reliable aesthetic units for objective assessment of the neck lift results. The Hyoid-to-Mastoid Crevasse neo-ligament can achieve greater angular definition and improved cervical contour while safely addressing the submandibular glands.

Background: Revision rhinoplasty poses unique challenges due to altered anatomy, limited graft availability, and a thinned skin envelope. Conventional soft-tissue grafts, such as fascia or softened cartilage, carry drawbacks of donor-site morbidity. Many revision rhinoplasty patients, particularly those with prior aggressive tip work, develop substantial intranasal or subcutaneous scar tissue. In the senior author's practice, which includes a large population of complex revision cases, these patients are often excellent candidates for "spare parts" surgery, in which existing scar tissue is repurposed as an autologous graft. This study evaluates outcomes using patients' own autologous scar tissue as a nasal tip onlay graft in revision rhinoplasty.

Methods: A retrospective review was performed of all revision rhinoplasties by a single surgeon from January 2019 to August 2024 in which autologous scar tissue, harvested from around the lower lateral cartilages, were utilized as a nasal tip graft. Demographics and outcomes were collected, including infection and revision rates. Inclusion required ≥12 months of follow-up. Infections were defined clinically and treated with antibiotics as indicated.

Results: A total of 2,755 charts were reviewed, with 734 patients undergoing revision rhinoplasty; 450 underwent scar tissue grafting while 284 required mastoid fascia due to insufficient scar tissue quality. Mean follow-up among the scar graft cohort was 22.8 months. Post-operative infection occurred in 6 patients (1.3%), all resolving with oral antibiotics. 13 patients (2.9%) underwent revision surgery, most commonly for under-projection (1.5%), breathing concerns (0.9%), or repeat deprojection (0.4%). No cases demonstrated appreciable graft necrosis, resorption, or skin envelope compromise.

Conclusions: Autologous scar tissue provides a readily available, pliable, and biocompatible material for nasal tip augmentation in revision rhinoplasty. This technique eliminates donor-site morbidity and additional operative time while maintaining low infection and revision rates. Scar tissue grafting represents a safe, efficient, and novel adjunct for contour refinement in complex secondary rhinoplasty. Patients with minimal or poor-quality scar tissue, may require alternative graft sources.

Does Epidural Anesthesia Improve Safety in Abdominoplasty? A Retrospective 100-Case Consecutive Series
Background Abdominoplasty carries meaningful morbidity, including venous thromboembolism (VTE) and Pulmonary Embolism (PE). Reported VTE/PE rates vary widely, and abdominoplasty-specific prophylaxis pathways remain inconsistently defined (1,2). Anesthesia technique may influence thrombotic risk and recovery, yet data are limited (3,4). We evaluated outcomes of 100 consecutive abdominoplasties performed under epidural anesthesia. Methods We conducted a retrospective single-surgeon, single-center consecutive case series of 100 abdominoplasties performed under epidural anesthesia with intravenous sedation and local infiltration (June 2018–September 2024). Thromboembolic risk was assessed using the Caprini score. Data collected included patient demographics, risk factors, operative technique, time to ambulation, post operative analgesic/antiemetic requirements, and complications. All epidural catheters were removed intraoperatively at the conclusion of surgery. All patients received mechanical VTE prophylaxis with sequential compression devices (SCDs) intraoperatively. One patient received chemoprophylaxis. Patients were observed overnight and discharged on postoperative day 1. Results Mean age was 49.6 years; 82% ASA II and 18% ASA I. Mean BMI was 26.03. History of diabetes mellitus was present in 2%, cigarette smoking in 3%, vaping in 3%, and post-bariatric status in 8%. All patients who smoked or vaped discontinued nicotine at least 4 weeks preoperatively. Mean operative time was 3 hours 32 minutes; the mean difference between operative time and surgery time was 46.8 minutes. Procedures included abdominoplasty (7%), abdominoplasty with liposuction (51%), abdominoplasty with concomitant breast procedures (38%), and other concomitant procedures (4%). Mean time to ambulation was 2 hours 25 minutes. Antiemetic medication was administered in 21%; there were no episodes of emesis, and the mean postoperative 24-hour analgesic requirement was 3.4 doses. No major complications and no DVT/PE. Conclusion Epidural anesthesia for abdominoplasty was associated with early ambulation and no DVT/PE in this 100-case consecutive series. Administration of epidural added an average of 16 minutes in the operating room. References 1. Keyes GR, Singer R, Iverson RE, Nahai F. Incidence and predictors of venous thromboembolism in abdominoplasty. Aesthet Surg J. 2018;38(2):162-173. 2. Ramon, Yitzchak MD; Yarhi, Danielle MD. Abdominoplasty under Epidural Anesthesia: Safer for the Patient, Easier for the Surgeon. Plastic and Reconstructive Surgery 134(4S-1):p 122, October 2014.
3. Hafezi F, Naghibzadeh B, Nouhi AH, et al. Epidural anesthesia as a thromboembolic prophylaxis modality in plastic surgery. Aesthet Surg J. 2011 Sep;31(7):821-4. 4. Smith LM, Cozowicz C, Uda Y, et al. Neuraxial and Combined Neuraxial/General Anesthesia Compared to General Anesthesia for Major Truncal and Lower Limb Surgery: A Systematic Review and Meta-analysis. Anesth Analg. 2017 Dec;125(6):1931-1945.

Background: Fresh-frozen costal cartilage (FFCC) has become an increasingly popular grafting material in rhinoplasty. Although complication rates are low, concerns persist that donor age may influence cartilage quality and surgical outcomes. It is widely believed among plastic surgeons that younger donors are the optimal choice for donor cartilage due to lower rates of calcification and greater elasticity. However, in the senior author's experience, grafts from older donors perform comparably and may offer advantages in rigidity due to increased calcification. This study evaluates whether donor age meaningfully impacts postoperative infection or revision rates following rhinoplasty using FFCC.

Methods: A retrospective review was conducted of patients who underwent open rhinoplasty using FFCC by a single surgeon between May 2018–October 2024. Inclusion criteria were ≥12 months of follow-up and availability of FFCC serial number data allowing confirmation of donor age. Donor ages were obtained from the manufacturer and grouped as ≤30 years (Under-30) and >30 years (Over-30). Demographics, infection, and revision rates were compared using chi-square and unpaired t-tests. Post-hoc analyses using donor-age cutoffs of ≤40 and ≤50 years were also performed.

Results: 343 out of 2,755 rhinoplasty cases met inclusion criteria. The mean follow-up was 18.7 months. There were no significant demographic differences between groups except for sex distribution, with a higher proportion of female patients in the Over-30 group (p = 0.031). The overall infection rate was 1.3% (n=4) and revision rate 3.8% (n=13). Both infection (p=0.140; p=0.359) and revision rates showed no statistically significant difference between groups. Post-hoc analyses revealed no additional associations.

Conclusions: Donor age did not significantly influence infection or revision rates following rhinoplasty using FFCC. These findings may be explained by the surgical technique used, wherein only the straightest portion of each FFCC graft is used after allowing at least 1-hour for thawing to reveal intrinsic warp. In this way, FFCC from older donors perform comparably to grafts from younger donors, supporting broader use of FFCC across a wide donor age range. Further research with histologic analysis of FFCC from donors of varying ages is needed to validate these clinical observations and clarify whether age-related cartilage changes have meaningful implications for graft performance.

Background: Panniculectomy is commonly performed to address excess infraumbilical skin and soft tissue following massive weight loss (MWL). MWL can be achieved through lifestyle modifications, bariatric surgery, and pharmacologic therapies, such as glucagon-like peptide-1 (GLP-1) receptor agonists. However, the distinct metabolic and physiologic effects of these weight loss modalities may influence surgical outcomes. The aim of this study was to evaluate whether the method of weight loss affects post-operative outcomes following panniculectomy in patients after MWL.

Methods: A single-center retrospective review was performed to identify patients who underwent panniculectomy from 2021 to 2025. Patients were grouped into four cohorts based on weight loss method: lifestyle modifications, bariatric surgery, GLP-1 agonist therapy, or combined bariatric surgery and GLP-1 agonist therapy. Variables of interest included patient demographics, comorbidities, wound healing complications, surgical site infection, seroma, hematoma, venous thromboembolism (VTE), antibiotic usage, emergency room utilization, and hospital utilization. For statistical analysis, we used ANOVA, chi-squared, and Fisher's exact tests. Multivariate logistic regression was performed to analyze post-operative complications and healthcare utilization while adjusting for potential confounding variables. A p-value of less than 0.05 indicated statistical significance.

Results: A total of 281 patients met our inclusion criteria (lifestyle modifications: n=53, bariatric surgery only: n=184, GLP-1 agonist therapy only: n=20, combined bariatric surgery and GLP-1 agonist therapy: n=24). Patient demographics, including age, sex, and race, were similar between the cohorts. BMI at the time of surgery, total weight loss, history of diabetes, history of chronic obstructive pulmonary disease (COPD), and history of VTE differed significantly between the groups. Multivariate analysis demonstrated that patients who underwent bariatric surgery only for weight loss had lower odds of seroma (OR 0.28, 95% CI 0.09-0.90, p=0.032) and lower odds of post-operative admission (OR 0.24, 95% CI 0.10-0.57, p=0.001) following panniculectomy compared to the lifestyle modifications cohort. No other significant differences were observed between the groups. Median follow-up duration was 109.5 days (IQR 48.3-196.3 days).

Conclusion: Our results show that bariatric surgery alone was associated with reduced odds of seroma and post-operative admission compared to patients who lost weight through lifestyle modifications. Pre-operative GLP-1 agonist therapy, alone or combined with bariatric surgery, was not associated with increased post-operative complications or additional healthcare utilization. These findings suggest that GLP-1 agonist therapy does not adversely impact panniculectomy outcomes in the MWL population. The results of this study can help guide patient counseling, risk stratification, and surgical decision-making for individuals pursuing panniculectomy after MWL.

Purpose Miami is a significant destination for medical tourism in aesthetic surgery, with many drawn to the lower cost associated with high volume budget clinics. Notably, we encounter an overwhelming number of patients that present to our hospital system with complications following an aesthetic surgical procedure performed in the local community. This study evaluates the financial impact that these patients have on our public healthcare system. Methods A retrospective review of patients presenting to a Jackson Health System facility between January 2023 and December 2025 with complications after aesthetic surgery was completed. A web search identified average hospital costs for inpatient and intensive care unit (ICU) stays, emergency surgeries, transfusions, and other interventions. Medicare cash rates were used to estimate direct hospital costs. Results There were 335 identified patients, 252 of which (75%) traveled from out of state for surgery. A total of 233 (70%) required hospital admission and 53 (16%) required ICU level care. Overall, 35 (10%) required an emergent surgery upon arrival to the hospital. Approximately half of patients (46%; n=154) required one or more transfusions. Total utilization included 875 inpatient days and 278 ICU days. Patients admitted to the ICU had significantly higher rates of operative intervention (40% vs 6%; OR 11.16, p<0.0001), transfusion (81% vs 57%; OR 3.29, p=0.0012), and intubation (15% vs 1%; OR 15.82, p=0.0001). The minimum three-year direct cost was calculated to be $2.22 million, averaging $9,528 per individual hospital admission. Across a mean ICU stay of 5 days, the average cost per ICU admission alone was $21,000; however, with additional imaging, transfusions, and procedures, the weighted cost per ICU patient averaged $41,361. When multiplied across the 53-patient ICU cohort, the total estimated ICU-related cost over the three-year study period was approximately $2.19 million. Conclusion Most patients presenting with aesthetic surgery complications from the local community lived outside of Florida. Patients frequently required inpatient and ICU level care, in addition to interventions like transfusions and surgery. Aesthetic surgery medical tourism and high-volume aesthetic surgery clinics may therefore place a significant financial strain on our healthcare system.

Introduction: Following substantial weight loss achieved through bariatric surgery or increasingly prevalent GLP-1 receptor agonist (GLP-1RA) therapy, patients frequently develop a symptomatic pannus and pursue panniculectomy to improve function and quality of life (1). Differences in weight loss trajectories and subsequent body composition between surgical and medical approaches may influence post-operative outcomes (2). This study compared panniculectomy outcomes among patients who underwent prior bariatric surgery versus GLP-1RA therapy. Methods: We performed a retrospective cohort study of panniculectomy patients within the Froedtert Health system (January 1990 – November 2025). Patients were categorized into two mutually exclusive exposure groups: (1) prior bariatric surgery without GLP-1RA use, or (2) GLP-1RA use without prior bariatric surgery. Outcomes studied included infection requiring antibiotics, seroma, hematoma, open wound requiring surgical intervention, wound dehiscence managed with dressings, scar-related complications managed medically, venous thromboembolism (VTE), revision surgery, and an overall complication composite. Multivariable logistic regression estimated adjusted odds ratios (ORs) comparing GLP-1RA vs bariatric cohorts, adjusting for age, BMI at time of panniculectomy, maximum historical BMI, comorbidities, smoking status, prior abdominal surgery, prior VTE, and perioperative steroid use. Adjusted event rates were estimated via marginal standardization. Analyses included patients with complete covariate and outcome data. Results: A total of 234 patients met inclusion criteria (bariatric surgery, n=160; GLP-1RA, n=74). Overall complications occurred in 53.8% of bariatric patients and 52.7% of GLP-1RA patients; adjusted odds did not differ significantly between the two groups (OR 0.93, 95% CI 0.52-1.70, p=0.836). Seroma demonstrated a non-significant trend toward higher risk in the GLP-1RA cohort (OR 2.14, 95% CI 0.97-4.68, p = 0.058). VTE was rare (3 total events), precluding stable adjusted modeling. Revision surgery occurred in 15% bariatric patients and 29.7% GLP-1 patients. After adjustment, GLP-1RA use was associated with significantly higher odds of revision surgery (OR 3.50, 95% CI 1.59-7.67, p=0.002). Across both groups, greater weight loss independently predicted fewer post-operative complications (p = 0.036), even after adjusting for comorbidities and BMI at time of panniculectomy.
Conclusion: In this single-center study, among panniculectomy patients, pre-operative GLP-1RA use was associated with increased adjusted odds of revision surgery compared with prior bariatric surgery, while overall and most individual complications were similar between the groups. Greater weight loss was independently associated with fewer complications across groups. As GLP-1RA utilization expands, larger studies are needed to confirm these findings and guide perioperative counseling for patients undergoing body contouring after medical or surgical weight loss.

As weight loss patterns and body composition changes may differ between surgical and medication-assisted approaches, it is important to compare postoperative outcomes between these populations to inform perioperative counseling and risk stratification. 1. Coriddi MR, Koltz PF, Chen R, Gusenoff JA. Plast Reconstr Surg. 2011;128(2):520-526. doi:10.1097/PRS.0b013e31821b62f0 2. Wang Z, Wang L, Zhang X, et al. JAMA Netw Open. 2026;9(1):e2553323. doi:10.1001/jamanetworkopen.2025.53323

PURPOSE: Opioid prescribing after surgery is common and can lead to negative patient outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), used for management of diabetes and obesity, are being explored as a possible treatment of opioid use disorder. Plastic surgeons are increasingly seeing patients with a history of GLP-1 RA use presenting for body contouring surgery and should be informed on how these medications influence postoperative opioid-related outcomes. Here we explore the impact of preoperative GLP-1 RA use on postoperative opioid prescriptions in patients undergoing panniculectomy.

METHODS: We performed a retrospective study using the PearlDiver database (Colorado Springs, CO) to examine the impact of preoperative GLP-1 RAs exposure (within 180 days before surgery) on postoperative opioid prescriptions in opioid-naïve (without opioid prescription fill in 180 days before surgery) patients undergoing panniculectomy. We examined oral morphine equivalent (OME) for initial fills (30 days pre- to 3 days post-operative) and for refills (4 to 90 days post-operative).

RESULTS: Of 26,612 opioid-naïve patients undergoing panniculectomy, 832 (2.81%) had preoperative GLP-1 RA use. Patients with GLP-1 RA use had significantly lower OME in the initial fill (OME difference 121, 95% CI 38-205, p <0.05) and refill (OME difference 330, 95% CI 16-644, p<0.05) time periods. These differences remained significant after multivariable regression.

CONCLUSIONS: Patients with preoperative GLP-1 RA use received opioid prescriptions with lower mean OME after panniculectomy. Surgeons should be aware of potential factors influencing opioid-related outcomes and use a tailored approach when prescribing postoperative opioids.

Background Periorbital edema and ecchymosis are common sequelae following rhinoplasty, yet comparative evidence remains limited. This meta-analysis evaluated the efficacy of steroids, tranexamic acid (TXA), natural supplements, and cooling gel/cold saline following rhinoplasty. Methods A systematic review and meta-analysis was conducted per PRISMA guidelines. searching PubMed, EMBASE, and Cochrane. After removing 1,315 duplicates from 6,540 identified records, 77 full-text articles were screened, and 33 studies were included in the final analysis. Interventions included steroids (dexamethasone and methylprednisolone), TXA (intravenously, topically, or orally), natural supplements (arnica and bromelain), and cooling gel/cold saline. Edema and ecchymosis scores at POD 1, 3, and 7 were analyzed using random-effects models reporting pooled Mean differences (MDs) with 95% Confidence Intervals (CIs). Heterogeneity was assessed via I². Results TXA demonstrated edema reduction at POD 1, with MD of -0.55 (95% CI: -1.09, 0.00, p=0.05), with topical TXA showing the greatest effect (MD −0.90), followed by IV TXA (MD −0.43), and oral TXA (MD −0.08). This was not sustained at POD 3 or 7. For ecchymosis, TXA showed significant reductions at POD 1 (MD −0.75; p=0.004), POD 3 (MD −0.75; p=0.01), and POD 7 (MD −0.48; p=0.02), with topical TXA showing largest effect across timepoints (MD −1.10, −0.92, at POD 1 and 3), followed by IV and oral TXA. Steroids significantly reduced edema across all timepoints (POD 1: MD −0.60, p=0.007; POD 3: MD −0.75, p=0.0003; POD 7: MD −0.34, p=0.006; I²=85–90%). On sub-group analysis, dexamethasone achieved significant edema reduction at POD 3 and POD 7, though its effect at POD 1 did not reach significance. Methylprednisolone demonstrated the greatest edema reduction at POD 1, however this effect attenuated over time and did not reach significance at POD 3 or POD 7. For ecchymosis, steroids showed statistically significant overall reductions at POD 1 (MD −0.81, p<0.0001), POD 3 (MD −0.85, p=0.0006), and POD 7 (MD −0.40, p=0.01). On sub-group analysis, dexamethasone achieved significant reduction of ecchymosis at POD 1 and POD 3 but not POD 7 (MD −0.37, 95% CI: −0.86 to 0.12), while methylprednisolone maintained significance from POD 1 through 7 (MD −0.44, 95% CI: −0.79 to −0.09). High heterogeneity was present across most timepoints (I²=54–81%). Natural Supplements did not achieve significance for edema at any timepoint (POD 1: MD −0.23, p=0.37; POD 3: MD −0.10, p=0.76; POD 7: MD −0.15, p=0.19). For ecchymosis, a borderline effect was observed at POD 3 (MD −0.35; p=0.05) but was not sustained at POD 1 or 7. Cooling Gel/Cold Saline demonstrated no significant effect on edema or ecchymosis at any timepoint, with high heterogeneity throughout (I²=84–98%). Conclusion Steroids and TXA represent the most evidence-based perioperative adjuncts in rhinoplasty. Steroids reduced both edema and ecchymosis significantly across all timepoints, with Dexamethasone showing more consistent edema benefit and Methylprednisolone maintaining ecchymosis significance through POD 7. TXA demonstrated consistent ecchymosis reduction across all routes, with topical TXA yielding the greatest effect, while its edema benefit remained limited. Natural supplements and cooling agents did not achieve significant reductions for either outcome.

Background: Glucagon-like peptide-1 (GLP-1) analogues are increasingly used for obesity management, yet their association with postoperative outcomes after body contouring procedures remains unclear. Methods: A retrospective cohort study was performed using the TriNetX Global Collaborative Network (167 healthcare organizations). Adult patients with overweight/obesity (ICD-10 E66) undergoing body contouring procedures (including panniculectomy/abdominoplasty and other excisional procedures; CPT 15830, 15847, 15832–15839, 17999) as well as mastopexy and gynecomastia surgery (CPT 19316, 19300) were identified. Patients were stratified by GLP-1 analogue exposure (ATC A10BJ) occurring within 6 months before to 6 months after the procedure. The index event was the first qualifying procedure, and outcomes were assessed from postoperative day 1 through 365 days. Propensity score matching (1:1) was performed on age and diagnoses of BMI (Z68), diabetes mellitus, and overweight/obesity, yielding 2,151 patients per cohort. Risk analyses were performed for seroma, hematoma, wound dehiscence, surgical site infection (SSI), nausea/vomiting/diarrhea, hypertrophic scar formation, and surgical site pain. Results: In the matched analysis, GLP-1 exposure was associated with significantly lower 1-year risks of seroma (5.0% vs 7.8%; RR 0.64, 95% CI 0.49–0.82; p<0.001), hematoma (4.0% vs 6.0%; RR 0.68, 95% CI 0.51–0.90; p=0.006), wound dehiscence (5.1% vs 8.8%; RR 0.58, 95% CI 0.46–0.74; p<0.001), and SSI (4.9% vs 7.2%; RR 0.68, 95% CI 0.53–0.87; p=0.002). Surgical site pain was also lower (8.6% vs 11.2%; RR 0.77, 95% CI 0.64–0.92; p=0.004). No significant differences were observed for nausea/vomiting/diarrhea (7.5% vs 8.2%; RR 0.91, 95% CI 0.69–1.20; p=0.502) or hypertrophic scar formation (2.3% vs 3.3%; RR 0.70, 95% CI 0.47–1.04; p=0.072). Conclusions: In a large, propensity-matched electronic health record network analysis of body contouring patients with obesity, perioperative GLP-1 analogue exposure was associated with lower rates of several one-year postoperative complications (seroma, hematoma, dehiscence, SSI) and reduced surgical site pain, without increased gastrointestinal adverse-event coding. Further prospective studies are warranted to clarify causality and to evaluate the impact of dosing, timing of discontinuation, and degree of weight change.