Patients using GLP-1 receptor agonists before panniculectomy experienced significantly fewer complications than those who underwent bariatric surgery first. Among 24,645 panniculectomy patients, GLP-1 users showed 38% lower odds of cellulitis, 23% reduced seroma risk, and 49% fewer hemorrhages compared to bariatric surgery patients, despite having worse metabolic profiles including higher BMI, HbA1c, and triglycerides. This finding challenges conventional surgical wisdom and reflects a paradigm shift in weight loss approaches. GLP-1 medications like semaglutide and tirzepatide preserve muscle mass better than bariatric procedures, potentially maintaining superior wound healing capacity and immune function. The metabolic preservation may explain why GLP-1 users, despite appearing higher-risk on paper, actually heal better surgically. For plastic surgeons, this data suggests GLP-1-mediated weight loss creates more favorable candidates for body contouring procedures. However, the study's observational nature and potential selection bias warrant caution—patients choosing medications over surgery may fundamentally differ in health status or adherence. This represents early but compelling evidence that the pathway to weight loss significantly influences surgical outcomes.