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As rates of obesity have increased in America, men and women have looked for solutions for weight loss. Over the past few years, Ozempic has become a “miracle drug,” being used by many for weight loss. Along with the weight loss that occurs when taking Ozempic, patients are also experiencing rapid fat loss throughout the body, leading to loose and excess skin along the body and the accelerated appearance of aging. This has led to an increase in procedures performed by Plastic Surgeons to help reverse these effects.

What is Ozempic and how does it work?

Ozempic, along with Wegovy, belongs to a class of medications, known as semaglutides. Ozempic was approved by the FDA for type 2 diabetes and was also found to cause weight loss. These medications mimic the natural hormone GLP-1 (Glucagon-like peptide-1), which plays a crucial role in appetite regulation and weight loss. As a result, these medications have gained widespread attention for their efficacy in reducing body weight and improving metabolic parameters.

What effects will it have on my body and how can they be fixed?

Rapid fat and muscle loss often accompanies long-term use of Ozempic. With this, patients develop excess skin along various portions of the body. The term “Ozempic Face” describes the characteristic changes to the face and similarly, the term “Ozempic Body” describes the various changes seen along the body, not only due to volume and fat loss, but also loss of collagen, elastin, and essential nutrients. I go into more detail about these effects below.

Breasts: Breasts are often composed of fat and glandular tissue. With the loss of fat, the breasts will decrease in size. With the rapid loss of volume, the skin along the breast will also get loose and droopy or ptotic – similar to changes seen following pregnancy and breastfeeding. To address these issues, we typically combine a breast augmentation using a breast implant to improve volume, along with a breast lift to remove the excess tissue and restore theyouthful shape of the breast.

Arms: With weight loss and volume deflation, the upper arms get thinner and have an improved contour. However excess skin along the upper arm develops, which can give the appearance of aging – something that cannot be improved with exercise. A combined procedure of liposuction to remove any remaining fat, with a brachioplasty (arm lift), is used to give a tightened and more youthful appearance to the arms.

Abdomen: Similar to changes following pregnancy, weight loss often leads to loose skin along the abdomen along with pockets of residual fat. To address the abdomen, a combination of Abdominoplasty, Liposuction, and Muscle Plication is performed. The abdominoplasty removes excess skin, liposuction removes excess fat to help improve the contour of the waist, and muscle plication aids in repairing a diastasis or muscle laxity that develops over time.

Buttock: With the loss of weight, patients notice a decrease in the volume of the buttock along with droopiness or ptosis of the gluteal region with excess skin. To smooth out the buttock and remove the excess skin, a body lift is done, which is often combined with, or is an extension of, an abdominoplasty. Excess skin along the lower body is removed using a well-hidden incision to improve the appearance of the buttock as a whole.

Thighs: Weight loss can also lead to the dreaded excess skin along the thighs, preventing patients from comfortably wearing shorts due to the sagging skin. This is treated with a thigh lift. Using a combination of liposuction and skin removal, the medial aspect of the thigh is addressed to give a tighter and more youthful appearance.

When is it safe to undergo surgery when taking Ozempic?

It is safe to have Plastic Surgery when taking Ozempic; however, certain factors should be met. You should make sure that you have met your target or goal weight and that you have remained at that weight for 3 to 6 months. This ensures that you are able to maintain the weight with a healthy lifestyle and that you will be able to maintain that weight postoperatively as well. It is also important that your doctor checks your blood levels for essential nutrients, including iron, vitamin B12, fat-soluble vitamins, and protein, all of which play a significant role in wound healing.

These can be decreased when on Ozempic, and if that is the case, surgical interventions should typically be postponed until nutrition is optimized.

Any precautions before surgery?

Ozempic can delay gastric emptying which can pose a health concern during surgery under anesthesia, because of the increased risk of gastric regurgitation. Current guidelines from the American Society of Anesthesiology target mitigating the risk of gastric regurgitation during general anesthesia in patients on these diet drugs. Their guidelines suggest stopping Ozempic one day prior in those patients on daily dosing, and cessation one week prior in patients on weekly injection dosing. If these medications cannot be stopped before surgery, then extending the recommended pre-operative fasting period from 8 hours to 24 hours or longer before surgery allows for a more complete emptying of gastric contents.

Should I continue using the medication after surgery?

Studies have shown that when Ozempic or Wegovy are no longer taken, patients do gain at least some of their weight back. As a result, we recommend maintaining your dose after surgery to keep your surgical result. However, it is always important to follow your doctor’s recommendations.

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