Background: The adoption of GLP-1 receptor agonists (GLP-1RAs) has shifted the demographics of massive weight loss patients requesting body contouring. Unlike bariatric surgery, GLP-1RA-induced weight loss may maintain nutritional markers but affect tissue microvasculature. This systematic review evaluated the current literature regarding surgical outcomes and complications in GLP-1RA patients undergoing body contouring. Methods: A systematic review was conducted of Pubmed, Embase, and MEDLINE (January 2010 - January 2026) for pertinent studies. Studies detailing patients undergoing excision body contouring after GLP-1RA use, versus a control group, were included. Randomised control trials, cohort studies, case-control studies, cross-sectional, and case series (n>2) were included. Quality was assessed with the Newcastle-Ottowa scale. A qualitative synthesis of study findings was undertaken. Results: Four papers meeting eligibility criteria, and assessed as moderate-to-high in quality (Newcastle-Ottawa Scale), were analysed. Findings suggest an association between GLP-1RA use and increased rates of delayed wound healing, wound dehiscence, and hypertrophic scarring compared to controls. Large scale analysis demonstrated significantly elevated risk of surgical site infection, whilst findings on seroma were heterogenous amongst studies. Conclusion: Despite optimising weight and metabolic markers (e.g. elevated prealbumin), GLP-1RAs paradoxically impair acute tissue repair, evidenced by increased dehiscence and hypertrophic scarring. This suggests a state of "subclinical malnutrition" wherein induced caloric deficit may compromise healing despite normal laboratory values. Surgeons should implement comprehensive nutritional screening beyond standard markers and consider preoperative cessation or targeted supplementation to ameliorate soft-tissue risks in body contouring procedures.