Even when weight loss becomes weight lost, your journey towards a new-you may not be over. As GLP-1 medications have shown their effectiveness and continue to rise in popularity, the aesthetic industry is rising to meet the moment of lost weight with the best in post-weight loss body treatments.
From skin-tightening procedures in brand-new places to breast reductions and lifts, plastic surgeons can provide the final touch to a major transformation. And their services are more in-demand than ever before. What was once a fairly niche part of plastic surgery is on trend to become the new standard. Here, aesthetic experts share the protocols to keep us all safe and the procedures that create the best result for a post weight-loss body.
Did you know?
According to healthcare industry research by Trilliant Health, providers wrote more than 9 million prescriptions for GLP-1 medications in the last three months of 2022 alone.
Featured Experts
- Eric Mariotti, MD is a board-certified plastic surgeon in Concord, CA.
- Mary Herte, MD is a board-certified plastic surgeon in Las Vegas.
- Simona V. Pautler, MD is a board-certified plastic surgeon in McMurray, PA.
- Leo R. McCafferty, MD is a board-certified plastic surgeon in Pittsburgh.
Goal Reached: A Rising Need for Post-Weight Loss Body Treatments
From Niche to Need
“I have a niche in the post weight-loss plastic surgery arena,” explains Concord, CA plastic surgeon Eric Mariotti, MD. “Until recently, this has been primarily through diet and exercise, as well as through bariatric procedures such as gastric bypass or a gastric sleeve— making the stomach smaller.”
As GLP-1 medications became a bonafide way to lose weight, more and more patients have begun seeking the kind of procedures Dr. Mariotti offers. These post-weight loss body treatments tend to be focused on dealing with the lax skin that fast weight loss can cause. And many are still actively taking these medications while doing so, leading to new protocols.
New Rules
“We are definitely seeing more surgical patients coming in while on GLP-1 meds,” explains Las Vegas plastic surgeon Mary Herte, MD. “And this poses an increased anesthetic risk, so we are requiring our patients to stop taking them for three weeks in advance to improve their safety at surgery.”
A recommendation from The American Society of Anesthesiologists for those who are on weekly dosing of GLP-1s is to hold their dose for at least a week. That increased risk has to do with the way these medications work.
“The food literally stays in your stomach longer,” explains McMurray, PA plastic surgeon Simona V. Pautler, MD. “And with anesthesia, if there’s a chance there could be food in your stomach, there’s a risk of aspiration.” Being honest with your surgeon about what medications you’re on is essential to remaining safe and ensuring a smooth procedure.
Top-Performing Procedures
Not everyone loses weight equally, and losing weight quickly can make some of those unexpected side-effects a bit worse. That includes things like skin laxity and muscle deterioration.
For those who are looking to eliminate the very last of stubborn bulk and rebuild muscle along the way, in-office treatments like Emsculpt or EmSculpt Neo are a solid option. A device that uses high-intensity focused electromagnetic energy (HIFEM) in combination with radio frequency (RF), Emsculpt Neo stimulates muscle contractions while also destroying the subcutaneous fat. “Emsculpt Neo gives an average of 30 percent loss of fat and 25 percent gain in muscle,” explains Jupiter, FL dermatologist Dr. Shawna Flanagan, adding that the average patient will require at least four treatment sessions about one week apart. “We usually see results within the first month, but the full results are not seen until a few months later,” they said.
The thing about losing weight is that the skin doesn’t bounce back, which creates laxity. In addition, patients are experiencing volume loss in areas they want to maintain, like the face.
“In my practice, breast and body contouring are the most requested surgeries,” explains Dr. Mariotti. “With age, pregnancy or significant weight loss with these newer medications, many patients are asking about procedures such as tummy tucks, breast lifts and other body-contouring procedures. Facial procedures have also increased in order to treat ‘Ozempic Face,’ a condition where facial fat is lost quickly.”
This patient lost 130 pounds and saw Dr. Mariotti to remove the loose skin on her lower stomach and thighs.
Skin-Tight Solutions
“You can’t exercise skin away,” says Dr. Pautler. “When you touch the back of a cat or dog, you can see their entire back twitch, right? That’s because they have muscles in their skin that humans don’t have.” Because we’re left with the skin we have, losing weight quickly can cause that excess skin to hang. Removing that loose skin ultimately requires surgery.
“Patients who have lost a significant amount of weight on GLP-1 medications tend to fall into two categories,” explains Pittsburgh plastic surgeon Leo R. McCafferty, MD. “One is men and women who have a lot of extra neck skin and are considering a facelift. The other is mostly women seeking typical body-contouring procedures in areas like the tummy, arms and legs.”
The Best of the Breast Procedures
Weight loss impacts all bodies differently, and the breasts tend to be an area of concern once a goal weight is achieved. If weight is lost in the breasts, patients may experience deflation, where a loss of volume causes breast tissue to sag and may significantly reduce its size.
I’ve actually had a few patients just this week who were initially considering breast reductions,” Dr. McCafferty says. “But after weight loss, they really only needed a lift and perhaps a small implant to restore shape and volume.”
If weight isn’t lost in the breast area, a breast reduction may be considered for balance. “Breast reduction might be needed to achieve better proportion after weight loss,” Dr. Herte explains. “Naturally large-breasted women generally do not lose weight in their breasts as readily as smaller-breasted women.”
Pump Up the Volume
Another key area that experiences volume loss is the face, which can create a gaunt look. This side effect can be particularly jarring, but there are ways to restore volume even before reaching a goal weight.
“Support of the facial structure with rejuvenation filler—for collagen stimulation—and judicious volumizing can keep a healthy and youthful look despite significant weight loss,” Dr. Herte says. “Family and friends can undermine a patient’s weight loss by making remarks about how gaunt or unhealthy they look as they lose facial fat, as well as body fat. In the process of weight loss, aesthetic injections can keep the motivation going until that ideal weight goal is reached and they can consider surgery to fine-tune their results.”
