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The Body Lift Era: What the 2025 Global Numbers Say About the Weight Loss Patient

Black and white photograph of four women of different backgrounds in dark fitted clothing standing in a line against a dark studio wall, faces shown, lit by a single hard light. Illustrative image, not patients. Frank Agullo, MD, FACS.

Liposuction is the number one surgery in the world, and in 2025 it fell 11.4 percent. Upper body lifts rose 38 percent. Buttock lifts rose 39. Lower body lifts rose 22. Arm lifts rose 13. That is the International Society of Aesthetic Plastic Surgery’s survey of procedures performed in 2025, published at the end of September. It never mentions weight loss medication. It does not have to.

We used to only talk about massive weight loss after bariatric surgery, like a Roux-en-Y or a gastric sleeve. But nowadays, massive weight loss also happens with GLP-1s. There is a rapid amount of weight loss, and the loss of volume deflates the skin that was previously stretched out. This ultimately sags and creates contour irregularities.

The Fat Is Already Gone

A lot of these patients losing weight fast are not taking in enough protein, so they’re also losing muscle. About a quarter of the weight loss is going to be muscle mass. So the body loses muscle mass plus the fatty content, and then we have the sagging in the buttock. Some patients have it in the inner thighs, the arms, the back. It’s a 360 thing. It’s the whole body, not just the tummy like most people expect.

Once the skin has been stretched out to a certain degree, it loses its elasticity and really doesn’t react to radiofrequency energy the same way healthy skin would. When the skin laxity is significant, the only option at this point is excisional.

What a Body Lift Actually Is

I think the gold standard for massive weight loss is usually performing an abdominal procedure, which entails a tummy tuck. But more often than not, because of the massive weight loss, this tummy tuck has to be extended circumferentially, so that we can lift the buttock and the lateral thigh, reduce the lower back, and fix the abdomen at the same time.

After a full consultation, we can determine whether you can undergo all the procedures at once, which usually entails an overnight stay and possible blood transfusion, versus breaking them up into parts. I think the most convenient way to break them up is to do the upper body, and then do the lower body.

The Part Nobody Posts

Body contouring surgery does entail surgical scars, but most of them can be hidden by normal clothing. The circumferential body lift can be hidden by swimwear or underwear. There are some procedures whose scars are a little harder to hide, like the arm lift, or brachioplasty.

Oftentimes the patients are willing to have these scars because of the amount of excess skin in these areas, and ultimately they will feel better in clothing than not doing anything at all.

The timing, the staging and the screening are in the full post on the Agullo Plastic Surgery site.

Why Me

Double board-certified, Mayo Clinic trained, Clinical Associate Professor of Plastic Surgery at Texas Tech, Castle Connolly Top Doctor 2014 through 2026. ISAPS says one surgeon in five performs an upper body lift. I am one of them.

Ready to Talk?

Call (915) 590-7900, text 1-866-814-0038, or book online. #StayBeautiful

Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

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You Lost a Hundred Pounds. The Skin Did Not Get the Memo: A Surgeon on the Body Lift

Black and white editorial portrait illustrating body contouring after major weight loss. Surgical commentary by Dr. Frank Agullo, MD, FACS.

Some of the most rewarding consultations I have are also, for the patient, some of the most maddening.

Sixty pounds gone. Eighty. A hundred. Bariatric surgery, a GLP-1, or sheer stubborn discipline, it does not matter which. They finished the part most people never do. And then they are sitting across from me genuinely upset, because the skin will not play along.

Here is the truth I hand them, pulled from real consultations and anonymized. The skin is not a willpower problem. It is a tissue problem. Willpower does not fix tissue.

Why the Skin Will Not Go Back

Stretch skin that far for that long and the elastic fibers give out. You can hit a beautiful weight, carve out a tiny waist, and still have skin hanging off the breasts, the belly, the inner thighs, the arms.

No squat program reverses that. The only thing that removes loose skin is surgery. I say it bluntly because I have watched too many people blame themselves for something that was never theirs to fix at the gym in the first place. That is precisely the work body contouring after major weight loss was built for.

What I Do for the Breasts

After massive weight loss the breast usually still has volume. It is just hanging very low. Most of the time a lift alone gives a beautiful result, no implant needed. I bring the nipple up, take out the excess skin, and because your skin has lost its elasticity, I lay a mesh on the inside so the result no longer leans on skin that cannot hold. Skip that mesh and everything drifts back down over the years.

When the breasts hang extremely low, I usually hold off on the implant during the lift. Moving the nipple a long distance up while adding an implant in the same sitting can choke the blood supply to that nipple, and that is not a gamble I take. The implant is an easy second step later. One breast almost always outsizes the other, so I trim the bigger side to match.

Standard Tummy Tuck or All the Way Around?

With a standard tummy tuck I make a low incision, pull out the excess skin, draw everything down tight, and repair the muscles up the middle and along the sides for that corset effect and a smaller waist. Liposuction goes with it.

After massive weight loss, though, the looseness rarely stays in front. It wraps around the sides and the back. So I often steer toward the circumferential procedure, also called a lower body lift. The incision carries all the way around, which lets me pull the skin down in front while lifting the outer thigh and the buttock in the same pass. When the laxity is not just frontal, this is the most complete option on the table.

If your laxity is I usually recommend
Mostly in the front A tummy tuck with liposuction
Wrapping around the sides and back A circumferential lower body lift
Hanging low at the breasts A breast lift, often with internal mesh
Loose on the inner thighs A thigh lift, staged thoughtfully

The Honest Tradeoff on Stubborn Laxity

The circumferential lift pulls everything down and in. But carry a lot of side-to-side laxity and you may still have some looseness up top when it heals. Erasing that completely takes a vertical incision, one that gathers everything in like a corset.

Most people would rather not wear that scar, because it is harder to hide. So I almost always park it as an optional second stage, done later only if the looseness truly bothers you. I am not in the habit of talking patients into scars they do not need.

And the Inner Thighs

Real excess skin on the inner thighs? Liposuction alone will not touch it. I run an incision in the groin crease that continues just below the buttock and pull everything up. Want it tighter still? That means a vertical scar down the inner thigh, which I again hold in reserve.

Let me be upfront. The thigh lift is the hardest of these to recover from. Right where the tension pulls upward, the incision tends to open a little, almost every single time. The good news is we just keep it covered with gauze, it closes on its own in about two to three weeks, and more often than not we never even have to revise the scar.

Why I Stage It This Way

I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Mayo Clinic plastic surgery fellowship alum, and a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. Body contouring after massive weight loss is never one operation that fits everyone. It is a plan. I would rather hand you a safe, powerful result today and keep the more aggressive scars in my back pocket than chase perfection in a single marathon surgery and gamble with your healing.

Ready to Talk?

If you have lost the weight and you are ready to deal with the skin, let us build a plan together.

For the patient-facing version, see the companion post on agulloplasticsurgery.com. For the El Paso treatment menu, see the version on swplasticsurgery.com.

Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.