How Ozempic and Plastic Surgery Are Colliding

In the aesthetic world, GLP-1 medications have gone from buzz-worthy to practice-defining. While the dramatic weight loss results are easy to see on social media, what’s not talked about enough are the physical changes happening beneath the surface and how they’re impacting plastic surgery outcomes.

Featured Experts

• Dr. Mokhtar Asaadi is a board-certified plastic surgeon in West Orange, NJ
• Dr. Mariam Awada is a board-certified plastic surgeon in Grand Rapids, MI
• Dr. Johnny Franco is a board-certified plastic surgeon in Austin, TX

GLP-1s Are Changing the Plastic Surgery Landscape

“Some of these patients come in and they’re medically not ready,” said West Orange, NJ plastic surgeon Mokhtar Asaadi, MD, who described patients with low serum albumin, swelling and poor healing capacity after long-term GLP-1 use. “They look malnourished… that causes a lot of swelling for them and you are going to get to a lot of trouble with them, especially for the mission of the seroma, which is fluid collection after you do the body surgery on them.”

For Dr. Asaadi, the takeaway is simple: if you’re not medically optimized, surgery should wait.

Others on the panel echoed concerns but shared a broader view of the medications’ impact. Grand Rapids, MI plastic surgeon Mariam Awada, MD, said she saw both pros and cons. “I saw so many positive things that then I started it myself,” she shared, explaining that after her cancer diagnosis and sudden menopause, she gained weight that was hard to lose—until GLP-1s. “I feel healthier than ever. I feel better than ever. I feel more confident than ever.”

Still, she emphasized the importance of lifestyle and nutritional support. “You definitely want to stop it before surgery,  and you definitely need to start being proactive, whether it’s increasing your protein intake, taking multivitamins and just eating very healthy.”

When to Get Surgery Safely After Ozempic

Stabilization is the key theme. “From an anesthesia standpoint, it is very important to ideally stop it at minimum a month before,” said Dr. Awada. “I prefer months before… then you know that they’ve stabilized, they’ve achieved their baseline and they’re not gonna rebound.”

Austin, TX plastic surgeon Johnny Franco, MD, who has treated over 1,500 GLP-1 patients monthly, sees them as a catalyst for change. “There’s not been a medication that’s had more of a ripple effect,” he noted. “You’re seeing really young patients with mature issues.” For him, it’s an opportunity for surgeons to help guide patients from the start of their journey through maintenance and aesthetic refinement.

Younger Patients, Older Concerns

This ripple effect is already changing the demographics of aesthetic consultations. Patients in their 30s and 40s are now presenting with laxity, volume loss and skin quality issues once reserved for much older patients. According to Dr. Franco, this is already reshaping long-term treatment planning. “You’re thinking about these 20- and 30-year-olds with more mature issues. It’s going to reshape how we approach anti-aging.”

How Regenerative Aesthetics Can Help

With skin and volume changes occurring rapidly after weight loss, regenerative aesthetics are more important than ever. “I get a phenomenal result with the nanofat,” said Dr. Asaadi. He uses it particularly around the eyes and mouth, where he says it avoids the lumpiness of traditional fat grafting.

Dr. Awada has used regenerative techniques for over a decade. “I called it prejuvenation,” she said. “You want to stay ahead of the game.” Her go-to options include PRP microneedling, radio frequency-based collagen stimulation, biostimulatory fillers like Bellafill and Sculptra and fat transfer to the face, breast and body. “People look better at three months than three weeks and nine months than three months,” she said of Bellafill in particular.

Dr. Franco emphasized that the excitement around exosomes and secretome therapies is real but needs more data. “There’s some really great products out there, but maybe not as well data-driven products, too.” He pointed to upcoming clinical trials that use a patient’s hair follicles to stimulate new growth factor production. “That opens up a lot of avenues,” he said.

Not Every Fix Is Surgical

Surgery isn’t always the answer—especially for younger patients or those in the early stages of transformation. “We try to get people involved in nonsurgical very, very early,” said Dr. Franco. “Hopefully, they can avoid some of these surgical treatments.” At the same time, he acknowledged that in cases of significant weight loss, surgery may eventually be needed to address skin laxity—especially in the lower body, where scars are more visible.

Dr. Awada shared her approach: “I always start with the most minimally invasive non-surgical, then differentiate the pros and cons.” Her tools include RF microneedling, lasers like Pico and ICON and VASER for surgical skin tightening without large incisions. “It’s my go-to for neck lipo with skin tightening,” she said, using it for arms and thighs when patients don’t want big scars.

For patients who’ve exhausted nonsurgical options, Dr. Asaadi offers surgical solutions that deliver dramatic skin tightening—often using energy-based liposuction paired with his decades of expertise. “You have to know what you are doing,” he said of using VASER. “It takes a bit longer, but the results are phenomenal.”

The Bottom Line

The GLP-1 era is changing not just bodies but the aesthetic decisions that follow. These medications are bringing in a wave of patients, some younger, some new to aesthetics, who need personalized, medically sound care.

Whether the path is surgical, nonsurgical or somewhere in between, the best outcomes depend on a comprehensive approach. That means proper timing, patient education and a renewed focus on regenerative strategies to restore what weight loss may take away.