It’s a new era of weight loss, and experts are seeing the impact all over the aesthetic industry. GLP-1s have undeniably changed the game for plastic surgeons, even more so for the experts in weight loss-related aesthetic procedures. For Louisville, KY plastic surgeon Chet Mays, MD, it means a distinct shift towards treating rapid weight loss patients. And rapid weight loss requires an approach all its own.
What Happens When You Take GLP-1s?
Medications like Ozempic, Wegovy and Zepbound activate the GLP-1 receptor, a hormone that’s released after eating.
“These medications work by suppressing the appetite and giving patients a sense of fullness, thus they are lowering their caloric consumption,” Dr. Mays explains. “By keeping calories low and increasing activity patients are able to lose weight.”
And unlike the traditional diet and exercise route, GLP-1s take the weight off fast.
“When you lose the weight rapidly your skin doesn’t have enough time to contract so you end up with more excess skin than if you lost weight slowly,” says Dr. Mays.
Surgeon Schedule: The New Normal
Dr. Mays has always treated weight loss patients at his practice, but the way these patients are losing weight is changing.
“I have more weight loss patients who are losing weight more rapidly,” Dr. Mays says. “As a result of that, they are experiencing hanging, loose skin on multiple areas of the body. Additionally, the rise in GLP-1s has led to a decline in surgical weight loss options, like gastric bypass, lap, bands and other similar procedures.”
As this method of weight loss continues to grow in popularity, there’s a visible impact on the body that plastic surgeons are increasingly addressing.
“We see the effects of weight loss from head-to-toe in our clients,” Dr. Mays says.
From Head-to-Toe
Starting from the top, you may have heard of the rise of “Ozempic face.’”
“Facial volume loss can cause accelerated facial aging,” Dr. Mays explains. “For this we are constantly adding volume back to the face. Whether it is with temporary hyaluronic acid fillers, collagen stimulators like Sculptra or even fat transfers in the operating room.”
Because rapid weight loss tends to lead to sagging skin, some patients require more than just volume.
“Sometimes, in these GLP-1 patients, the skin is becoming so lax in the face and neck we are doing facelifts and necklifts at a younger age,” Dr. Mays says. “And as you move down the body, we are removing excess skin after rapid weight loss everywhere.”
Weight loss impacts everyone differently, and what’s becoming known as an “Ozempic makeover” can be any combination of procedures used to treat excess skin and loss of volume. And where traditional means of volume restoration aren’t available, experts have had to adjust their approach.
“When it comes to loss of volume in the buttock area, we would traditionally do a fat transfer or Brazilian Butt Lift,” Dr. Mays explains. “But these patients do not have the fat to transfer so we are doing the nonsurgical butt lifts with Sculptra and hyperdilute Radiesse.”
GLP-1 Advice from an Expert
If you’re considering GLP-1s for weight loss, Dr. Mays has some critical advice.
Consult a Healthcare Provider
“The medications are great, you just need to be followed by a medical professional,” Dr. Mays explains. “They can keep track of your labs and your dosing and make sure there are no side effects from the medication.”
Practice Healthy Habits
“Staying hydrated, eating protein and working to build muscle mass are all crucial when you’re on these weight loss medications,” Dr. Mays says. “If you are considering cosmetic surgery while on these medications, you need to prepare for surgery with your nutrition. Getting supplemental protein packets a few weeks before your surgery is critical to your recovery process. We give patients in our practice a two-week supply of Juven Wound Care Nutrition before their cosmetic procedure if they are on the weight loss shots.”
Pausing Your Medication for Surgery
“As you approach your surgery, you are going to be required to stop taking these medications,” Dr. Mays explains. “These shots slow your gastric emptying and make you feel full, which is how they achieve weight loss. But on the other side, if you’re going to have general anesthesia, you do not want a full stomach prior to surgery. So, stopping these medications and letting the G.I. system wake up before surgery is critical.”
Restarting Your Medication After Recovery
“We do not recommend returning to your weight loss medication until you’ve made it through your recovery,” Dr. Mays says. “Your body needs adequate nutrition to recover from surgery. If you start the shots too soon, you’ll have loss of appetite and poor nutrition, and therefore poor incision healing.”
