Newsweek ran it on August 12 under the headline “GLP-1 Use Could Boost Risky US Plastic Surgery Demand.” The setup was a Gallup number: injectable GLP-1 use for weight loss has nearly quadrupled since 2024, and about 11 percent of Americans are on some form of the drug, which is more people than smoke. The payoff was a 2026 study of 552 patients that found the more weight people lost before abdominal contouring, and the faster they lost it, the more complications they had.
I was one of the sources the reporter asked in July. I sent my answer. It did not run. That is fine; a piece has room for two voices, not twenty. But the answer is still the most honest thing I have on the subject, so here it is, in the words I sent.
The first thing I told her is what the drug does, and what it leaves behind.
“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.”
“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. That is why we are seeing so many of these patients in the operating room. The medication got them most of the way, and surgery finishes the job.”
And that the demand the story is worried about is not new. It is bigger.
“The most dramatic change I have noticed in my practice over the past two or three years is how patients have become different. Many patients arrive in my practice requesting excess skin sagging removal after massive weight loss thanks to semaglutide, tirzepatide, or one of the other new medications for weight loss.”
The devices get asked about first. I was honest about where they stop.
“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.”
Then the part the headline was really about. “Risky” is a timing problem, and timing is something a surgeon controls.
“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.”
“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. Performing surgery too soon often leads to poorer outcomes and an increased risk of complications.”
That is the whole answer. The study Newsweek leaned on and my rule in the consult room say the same thing from two directions: the patient who is still dropping weight fast is the one you do not operate on yet. Who is actually a candidate, with the table of what works and what does not, is in the full post on Agullo Plastic Surgery. The device side is on Southwest Plastic Surgery. My first pass at this, from before the Reuters and Newsweek pieces, is here, and the men’s version ran yesterday.
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I am Frank Agullo, MD, FACS, double board-certified, Mayo Clinic fellowship trained, Clinical Associate Professor of Plastic Surgery at Texas Tech, Castle Connolly Top Doctor 2014 through 2026. Call (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com/appointments. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.