The New Normal: Weight-Loss Drugs and Plastic Surgery

The New Normal: Weight-Loss Drugs and Plastic Surgery featured image
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If one thing is obvious to plastic surgeons all over the country, it’s that weight-loss medications are rapidly changing the aesthetic industry. The rising popularity of these medications and their impact on bodies have caused major shifts in the average age of cosmetic patients as well as their core needs.

Experts like Miami plastic surgeon Sean Simon, MD are rising to meet the moment through quickly adopting new industry standard protocols, refining their current techniques and helping patients resolve issues like volume loss and sagging skin.

Weight Loss Drugs Have Changed the Game

Plastic Surgery Adapts to GLP-1s

While Glucagon-like peptide 1 (GLP-1) is a hormone produced in the gut and released in response to food, its drug form was initially developed to treat diabetes. However, its impact on gastric emptying has propelled it to superstardom in the realm of weight loss. Thanks to its ability to delay gastric emptying and reduce food intake, patients have experienced significant weight loss, with an average reduction of 15 percent of their body weight. This weight loss occurs rapidly, making these medications highly effective in combating obesity.

“Significant weight loss impacts body fat distribution as well as tissue tone and potential laxity,” Dr. Simon explains. “Like all forms of weight loss, it is most appropriate to obtain a stable ideal body weight prior to plastic surgery as the result can be optimized and long lasting.”

Patients who aren’t at their goal weight do not make good candidates for this reason.

“If there is significant weight loss after a plastic surgery procedure, there may be degradation of the quality of the results secondary to loose tissue and skin,” Dr. Simon says.

Patients taking GLP-1s, alongside new rules provided by the American Society of Anesthesiologists, should consider the possibility of non-uniform fat loss, as well as the impact of loose skin and volume loss.

Those new rules include stopping your medication a minimum of ten days prior to any surgery, due to the increased risk of aspiration.

Where You Lose the Weight

Weight Loss Drugs and Fat Distribution

When you lose weight with GLP-1 medications, there’s a chance the fat you lose may not appear uniform, causing an imbalanced look. This specifically can occur in the stomach area, where semaglutide and tirzepatide medications are creating a significant impact in areas that are particularly difficult to lose weight in.

“GLP 1 reduction of visceral fat, or ‘internal fat’ found in the abdominal cavity and surrounding organs, is very important as it can often be quite difficult to lose and cannot be specifically targeted with exercise,” Dr. Simon explains. “We also can’t address this kind of fat surgically. That said, non-uniform fat loss with the use of GLP-1 meds may occur.”

Treatments involving liposuction and body contouring are targeted to address areas of need which can aid in optimizing the results achieved from weight loss and ensure a balanced look. 

The “Ozempic Face” Problem: Losing Weight Too Quickly

Perhaps the most infamous side effect of GLP-1 weight loss is the dreaded “Ozempic Face,” where weight loss leads to a gaunt and older look.

“Rapid weight loss from medications such as GLP1 may result in worsened elasticity compared with more gradual weight loss,” Dr. Simon says. “Nutritional support, adequate protein intake, hydration, and moisturizers help maintain collagen preservation and general health during rapid weight reduction.”

Additionally, patients who find themselves dealing with excess or sagging skin after reaching their goal weight may be good candidates for a facelift or necklift.

“While facelifts are a great option, volume restoration may need to be an important component of that facelift,” Dr. Simon explains.

Expert Advice

“As these medications have become extremely popular over the past couple of years, I’ve seen many patients in consultation that have used or are currently using these types of weight loss medications,” Dr. Simon says.

For them to achieve the best, most lasting results, he recommends a strong patient plan.

“My general advice to them is to have a plan,” Dr. Simon says. “In other words, what is the goal with regards to their weight loss? Is it a specific number on the scale? What kind of timeframe for being on the medication do you have?”

Ultimately, patients should be at least close to their goal weight before beginning to address the cosmetic side of their weight loss. Additionally, while these medications certainly represent an astronomical shift in how we approach and view weight loss, they aren’t a blanket solution to weight-related health issues.

“Patients should consider evaluating their diet while on the medication and perhaps learn a new eating strategy to continue after their time on a GLP-1 has ended,” Dr. Simon adds.

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