The Impact of a Composite Cardiometabolic Burden on Body Contouring Outcomes: Is the Whole Greater than the Sum of Its Parts?

Background: Body contouring surgery is a critical aspect of reconstructive and esthetic care, addressing both functional and psychosocial needs. As the global prevalence of obesity and related metabolic disorders is constantly on the rise, it is inevitable that patients presenting for body contouring procedures would display comorbid cardiometabolic conditions that can negatively impact surgical outcomes. Clustered cardiometabolic abnormalities have been linked to increased rates of surgical complications, medical adverse events, prolonged hospitalization, and need for revision procedures. However, its impact on body contouring surgery outcomes remains insufficiently characterized. Materials and Methods: TriNetX Global Collaborative Network, comprising deidentified electronic medical records from over 170 healthcare organizations was utilized for this study. Adults undergoing body contouring surgery were stratified by the presence of a composite cardiometabolic burden, defined as the combination of obesity, diabetes mellitus and hypertension, in the year preceding surgery. Cohorts were matched 1:1 using propensity score matching based on baseline demographics, comorbidities, and substance use. Risk ratios with 95% confidence intervals were calculated, with statistical significance set at p < 0.05. Outcomes were assessed at 30, 60, and 90 days postoperatively. Results: Among 188,164 body contouring patients, 6892 with composite cardiometabolic burden were propensity score–matched to controls. The study group was associated with significantly higher wound complications, surgical site infections, antibiotic use, and emergency department visits at 30, 60, and 90 days postoperatively, with no difference in hypertrophic scarring. Conclusions: Composite cardiometabolic burden, as defined in the study, demonstrated a significantly increased risk of adverse events following body contouring surgery, including wound-related morbidity, surgical site infection and increased healthcare utilization. These risks are evident from the early postoperative period and persist through at least the first 90 days after the procedure.