In August, Newsweek reported that GLP-1 use could boost “risky” plastic surgery demand. Gallup put about 11 percent of Americans on some form of the drug, nearly four times the 2024 number, and a 2026 study of 552 patients tied fast weight loss before surgery to more complications. The reporter asked for experts in July. I sent my answer, and it did not run, so here is the med spa half of what I told her.
The question I get at Southwest Plastic Surgery every week is the same one: the weight is gone, the skin is not, can a device fix it? Sometimes. Here is how I decide.
First, the mechanics, which have not changed.
“The medication takes the fat out of the body but does not tighten skin, which is stretched from the fat in the patient’s body. After losing weight (40-100 pounds) on Ozempic or another GLP-1 drug, patients find excess hanging skin along the abdomen, arms, inner thighs and neck because decades of stretching diminished their skin’s elasticity.”
Here is what the devices actually are, and what they are good at.
“There are noninvasive options like cryolipolysis that use a controlled freezing temperature to kill fat cells, along with other energy-based fat reduction devices designed to destroy or shrink targeted pockets of fat using lasers, heat or radiofrequencies. Some machines tighten skin using radiofrequencies or sound waves that help to minimize the sagging look of lost elasticity.”
“Patients favor these methods due to their noninvasive nature, which entails zero downtime and no need for anesthesia.”
And here is where they stop. I would rather tell you this at the consult than after you have paid for a series.
“While some work best for patients with minor fat deposits and good underlying skin tone, I want patients to understand how these technologies perform for the type of skin loss seen with GLP-1 weight loss: they do little to address significant overhang or drooping that requires a medical professional. When the problem of excess skin is severe, surgery remains the most effective solution.”
“Honesty in consultations is paramount. We must address the correct issue, as a patient predominantly dealing with excess skin will undoubtedly be displeased with a device treatment.”
The line I gave the reporter for direct use sums it up.
“The GLP-1 medications solve the fat. They do not solve the skin. When someone loses 60 or 80 pounds, the skin that was stretched for years does not snap back, and no cream, freeze, or laser will lift it.”
The Honest Sort
| What I see at the consult | Med spa answer | Surgical answer |
|---|---|---|
| Stubborn pockets, skin that still snaps back when pinched | Cryolipolysis or an energy device, Morpheus8 for the surface | Not needed |
| Mild laxity, no fold, no overhang | Morpheus8 or BodyTite; liposuction with Renuvion J-Plasma if there is fat too | Usually not needed |
| A fold you can lift with your hand | None that will satisfy you | Tummy tuck, arm lift or thigh lift at Agullo Plastic Surgery |
Whichever Side You Land On, the Weight Has to Stop Moving
This is where the Newsweek study and my own rule agree. Our GLP-1 program at Southwest Plastic Surgery is built around it.
“Another common piece of advice I impart is to achieve a stable weight before surgery. I require approximately two to three months of consistent weight without any significant fluctuations.”
“We must consult both me and your prescriber about your medication, as not all candidates are suitable for surgical intervention. Active smokers should abstain, patients with uncontrolled medical issues like elevated blood glucose levels should wait, and individuals who are still losing weight at a rapid pace must first achieve stability.”
Who is actually a candidate for the surgery, and what each operation does, is in the full post on Agullo Plastic Surgery. My commentary on the Newsweek piece is on Dr. WorldWide. The timing rule in full is in Body Contouring After Weight Loss, what a GLP-1 consult here looks like is here, and the men’s version ran yesterday.
Ready to Talk?
If you are not sure which side of the table you are on, that is what the consult is for. Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
