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Doctors Debate the Pros and Cons of GLP-1 Injections and Plastic Surgery

Doctors Debate the Pros and Cons of GLP-1 Injections and Plastic Surgery featured image
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This article first appeared in the Fall 2024 issue of New Beauty. Click here to subscribe

The advent of GLP-1 medications like Ozempic, Wegovy and Zepbound has revolutionized weight loss, achieving results that were once thought to be unattainable. These weekly injections reshape bodies and push demand for cosmetic treatments and tweakments. But is it a good thing?

1 in 8 U.S. adults have used a GLP-1

Source: KFF Health Tracking Poll

Austin, TX, plastic surgeon Johnny Franco, MD, is one of the millions who have experienced success with GLP-1 medications. Having lost more than 80 pounds, he has also helped countless patients follow their weight-loss journeys by offering injections at his practice. “One of my recent talks at a plastic surgery conference was on whether semaglutide should be involved in plastic surgery. Whether we like it or not, I think that ship has sailed. It’s here whether plastic surgeons are offering it or not.”

62% of GLP-1 users worry about loose or sagging skin after reaching their weight-loss goals

Source: State of Aesthetics

Tightening Trend

GLP-1s are driving higher demand for treatments that address loose skin, with fat-reduction procedures taking a backseat. “Skin laxity is going to be one of the biggest issues for the next 10 to 15 years,” Dr. Franco notes. Newton Centre, MA plastic surgeon Joseph Russo, MD, adds, “For patients who use GLP-1s before a tummy tuck, we can make them tighter and get better results.”

Pounds to Procedures

Angelina Otto, surgical coordinator for Dr. Russo, says that after losing weight with a GLP-1, her face needed attention. “I had liposuction with Renuvion to tighten my neck and Sculptra to fill in where I needed it.” She now helps patients navigate their weight-loss injections and advises on which treatments to get and when. “When you reach your goal, you might still notice things that bother you.”

Newport News, VA, plastic surgeon Michael Zwicklbauer, MD, who also lost weight with a GLP-1, experienced side effects that led to an ER visit, but he still recommends it. “I noticed volume loss in my face, so I had Sculptra filler injected, and I am much happier. The 25 pounds I lost have made working out easier, and my blood work has never been better.”

Liposuction was the top surgical procedure last year

Source: The Aesthetic Society National Databank Report

Pittsburgh plastic surgeon Jeffrey Antimarino, MD, says he’s seen a boost in GLP-1 patients coming in to fine-tune their bodies, and like his gastric bypass patients of the past, they just want to complete their journeys. “We’ve definitely seen an increase in patients wanting to treat areas they’d like to improve as they lose weight,” he explains. “I think it’s a good thing for plastic surgery. Patients lose weight and fat in different ways, so there are always going to be pockets of fat that may not be able to be reduced with GLP-1s. As plastic surgeons, we can help address those areas.”

7%: The increase in breast lifts in the past year

Source: American Society of Plastic Surgeons

Ballet Body Boom

Adjusting to a smaller frame is also a focus, as a recent American Society of Plastic Surgeons report shows a rise in procedures to achieve a slender aesthetic. Known as the “Ballet Body,” the look is largely attributed to the GLP-1 boom. “Part of the Ballet Body trend is at least partially due to the fact that these drugs have proven very effective in helping people to shed pounds,” says Oakland, CA plastic surgeon and ASPS president Steven Williams, MD. “This may be a reflection of their desire to be leaner, which is now possible because of the advancements in medicine.”

Risks and Rewards

Some doctors acknowledge the benefits of GLP-1s but say they also come with some drawbacks. Grand Rapids, MI, plastic surgeon Bradley Bengtson, MD, explains, “It’s not a panacea. On the surgical side, patients must pause their medication due to anesthesia concerns, and we need to book them far in advance due to gastric emptying times. We also have the challenge of navigating these injectables and the growing number of medspas prescribing them. While there are effective ways to provide for and monitor patients on injectables, it’s crucial to prioritize patient safety.”

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