Plastic Surgeons Are Reporting A Rise In Patients Asking For This Ozempic-Related Treatment

Yahoo

2 days ago

Dramatic weight loss can sometimes come with dramatic side effects.
And that's never been truer than it is now, thanks to the rise of popular GLP-1 medications like Ozempic. These injections are making the goal of shedding stubborn pounds within reach, but patients who've had success using them are noticing certain aesthetic downsides, including loose skin (a phenomenon that's been dubbed 'Ozempic face') and sagging (the charmingly titled 'Ozempic butt'). One study has even linked GLP-1 use to hair loss.
Sure, the physical transformation of a slimmer frame can result in feeling of accomplishment, but dealing with flat-looking features can erode those happy vibes, which may be why more and more people are turning to plastic surgeons for solutions. Yes, there are ways to tighten skin without surgery, but for the best—and most lasting—results, patients are opting for what's now being called the the 'Ozempic makeover.'
This comprehensive approach to addressing the head-to-toe cosmetic changes caused by GLP-1-induced weight loss is typically comprised of surgical and nonsurgical face and body procedures geared toward improving slack skin, re-contouring certain areas for a more defined appearance, and bringing volume to areas where a loss of fullness is evident. Think of it as a highly personalized one-stop-shop that tightens, re-inflates, and spruces up every commonly affected area, including the face, breasts, stomach, butt, and beyond.
Here, top plastic surgeons and cosmetic dermatologists break down the trend—and explain why, for those with the means, it's providing an extra layer of confidence.
The full picture.
GLP-1 medications such as Ozempic, Wegovy, and Mounjaro have been a godsend for those struggling to lose weight and, to be clear, a healthy weight far outweighs any appearance-related concerns, stresses New York plastic surgeon Ryan Neinstein, MD. But sometimes, the rapid weight loss that accompanies the use of these medications can have unexpected appearance-related outcomes. "Unlike with more gradual weight loss, GLP-1 patients often experience a 15% to 25% body weight reduction over 12 to 18 months." he says. Dropping pound so swiftly doesn't always allow the skin the time or sufficient elasticity to retract, particularly in thinner areas like the face.
The same can also be said for bariatric surgery and crash dieting, of course, but there may also be some unique factors at play, says New York dermatologic and cosmetic surgeon Hooman Khorasani, MD. "It appears that GLP-1 medications act on catabolic hormone receptors, breaking down fat and protein, like the collagen and elastin found in skin." Muscle mass can also be a casualty, compounding the problem. While fat helps to maintain skin tension and body contours, muscle acts as underlying scaffolding, and losing it—especially in bulky areas like the torso and legs—prevents skin from draping as it should, resulting in a loss of definition.
So, while it's clear these medications are effective, there's a trade-off. And that's given rise to a demand for treatments to help remedy these aesthetic changes: A new survey confirms what our experts already know—that GLP-1 use has created a dramatic shift in how patients are interacting with medical aesthetic procedures, with people bundling treatments for comprehensive full-body results. "Bottom line, people want to look as good as they feel," Dr. Neinstein says. "A lot of weight loss patients experience a tremendous health transformation and want their appearance to reflect that. They don't necessarily want to look 20 years younger—they just want to be the best version of themselves." As a result of this demand, Dr. Neinstein started offering Ozempic makeovers that combine elements of his popular Mommy Makeover with techniques specific to weight loss.
It's an approach that's hardly limited to just his office.
Enter the 'Ozempic Makeover.'
Often consisting of a combination of customized surgical and nonsurgical treatments, common elements of this head-to-toe refurb include:
Tummy tuck with muscle repair
Arm lift
Thigh lift
Breast augmentation
Volume restoration with fillers, injectables, or fat
Lasers
Tissue-stimulating peptide therapy
Facelift and neck lift.
The overarching commonality is that there isn't one: "Not all people experiences the same degree of facial and body changes with GLP-1 medications,' says Beverly Hills, CA, board-certified plastic surgeon Gabriel Chiu, MD, 'Weight loss-related changes vary based on individual factors, including age, genetics, and even sun exposure."
As a result, the solutions will vary. Dr. Khorasani eschews a one-size-fits-all approach, instead creating individualized plans. "Every person who comes through my office undergoes a detailed consultation, including a physical exam and comprehensive medical history review, to develop a tailored strategy featuring cutting-edge technologies," he says. And the mix of invasive and non-invasive therapies means there are solutions for every budget.
Some of the most common issues addressed by the Ozempic makeover include:
Sagging Breasts
Since the breasts naturally store a large amount of fat, a rapid depletion can impact the skin's ability to naturally drape over the contours of the chest, leading to a saggy or flat appearance. "Breast changes after GLP-1 weight loss are unique," says Dr. Neinstein, "since we see volume loss and skin laxity."
To restore what was once perky, Dr. Neinstein performs breast lifts with augmentation, using either implants or fat grafting (if there's enough fat left) to restore fullness to the upper part of the breasts and reshape. The surgery can be done in stages, if necessary, with the lift first and augmentation later, once the breasts have fully healed so the doctor can assess the new shape.
Drooping buttocks
Not only can a decrease of fat in the butt make it look smaller, there may be more pronounced cellulite too. That's because cellulite, which forms when fat pushes up against fibrous bands of tissue called septae, is affected by how the remaining fat is distributed. "Right now, there is an increased demand for buttock augmentation either with implants or fat grafting since people lose so much volume in this area," Dr. Neinstein says.
Sculptra injections are also a surgery-free way to enhance the butt, while Dr. Chiu likes Renuvion (sometimes called J-Plasma), a radiofrequency (RF) and helium plasma skin tightening procedure, to help lift, tighten, and reshape the butt. During the treatment, a special wand is inserted under the skin through tiny incisions to heat the tissue and induce controlled collagen contraction for firmness and more lifting. "The skin tightens instantly and continues to improve over six to nine months," Dr. Chiu says.
Excess skin
This can crop up anywhere, but especially on the abdomen, arms, and thighs. Nonsurgical RF microneedling treatments are ideal for improving skin texture, especially in crepey skin accompanied by stretch marks. These treatments deliver a dose of thermal energy into the deeper layers of skin to reach fibroblasts, which are responsible for stimulating the building of new collagen and elastin, thereby improving skin texture and firmness. Dr. Chiu says the most popular RF microneedling treatment is Morpheus8.
He also opts for other nonsurgical treatments, such as Emsculpt, when rebuilding and restoring muscle definition is necessary. Emsculpt relies on radiofrequency heating and high intensity focused electro-magnetic (HIFEM) technology to burn fat while firming and toning the muscles for improved strength and muscle mass. That scaffolding? Restored. But for more severe skin laxity, a tummy tuck "improves excess skin while tightening the abdominal muscles," says Dr. Chiu. Liposuction, often paired with a skin-tightening procedure, is another option to remove stubborn pockets of fat that may remain after weight loss and refine a particular area.
Inner thigh lifts, in particular, are becoming increasingly common after weight loss with GLP-1s. "Skin laxity in this area can cause functional issues with chafing and hygiene," Dr. Neinstein explains. "The upper back and bra line also develop loose skin rolls that may require surgical excision." Dr. Neinstein is also seeing a rise in lower body lifts, which he says address changes to both the abdomen and back and flanks in a single surgery.
'Ozempic face'
A 2023 survey from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) found that 15% of facial plastic surgeons recommend treating Ozempic face exclusively with facial filler, 12% recommend face and neck lifts, and 2% recommend fat grafting. "Biostimulatory fillers like Sculptra and Radiesse create a more youthful, balanced profile and hyaluronic acid fillers to help with contour restoration," Dr. Khorasani says.
Fat transfer, a popular option for those who have sufficient fat to spare through a liposuction-like procedure, also restores lost facial volume. To help tighten the skin nonsurgically, go-to treatments include collagen-stimulating RF microneedling and ultrasound-based therapies such as Ulthera and Sofwave, which help lift and tighten the skin, and ablative and non-ablative tightening lasers used with PRP, PRF, or exosomes.
Dr. Khorasani relies on a layered approach that combines RF microneedling with fractional laser resurfacing and regenerative medicine. "I often use Morpheus8 (RF microneedling) to target the deep dermis and subcutaneous tissue to tighten the skin and subtly improve the contour along the jawline and cheeks," he says. "Then, I pair it with CO₂ laser resurfacing to refine the skin texture, reduce fine lines, and stimulate collagen production." He often also uses these treatments, in addition to FaceTite (which uses directional radiofrequency energy), to target more significant laxity and fullness in the lower face and neck, further boosting the results. "In some cases, liposuction is needed to refine the jawline further and remove stubborn fat beneath the chin, followed by RF skin tightening."
Looking—and feeling—your best.
The bottom line is that most people go on GLP-1 medication to improve their health—and that should always be the main goal. Weight loss undoubtedly helps to reduce the risk of disease and provide a better quality of life. But if aesthetic related concerns are troubling you, modern medicine has a solution.
With more and more weight loss medications on the horizon and innovative technologies to address the drawbacks popping up almost monthly, the Ozempic makeover trend shows no signs of slowing down. While Dr. Neinstein predicts that weight loss medications will likely improve to predominantly target fat and spare muscle, resulting in less loose skin, for now, a plastic surgeon may be your best option.
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