November 13, 2026 | Body Contouring, Weight Loss
In August, Newsweek ran a story under the headline “GLP-1 Use Could Boost Risky US Plastic Surgery Demand.” The numbers behind it are hard to argue with. Gallup says injectable GLP-1 use for weight loss has nearly quadrupled since 2024, and about 11 percent of Americans are now on some form of the drug. That is more people than smoke. The “risky” part came from a 2026 study of 552 patients: the more weight a patient lost before abdominal contouring, and the faster they lost it, the higher their complication risk, highest of all in people who combined bariatric surgery with a GLP-1.
The reporter asked for experts in July. I sent my answer. It did not make the piece. Here is what I told Newsweek, in the words I sent, with the one thing the article circled but never landed on: who is actually a candidate, and when.
What the Drug Does and Does Not Do
Start with the mechanics, because the whole consult turns on them.
“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 volume lost also affects the face and breasts (making some look older). None of the drugs solve these mechanical problems.”
That is the line I gave the reporter for direct use, and it is still the clearest way I know to say it.
“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.”
What the Surgery Is
Post-GLP-1 body contouring is not one operation. It is a family of them, and most patients need a combination.
“It is post-GLP-1 body contouring, which is the surgery to remove lax skin or persistent bulges of fat after losing significant amounts of weight while using GLP-1 medications. This surgery takes off the excess, sagging skin, while additionally removing persistent bulges of fat that did not shrink even with large weight loss amounts.”
“Generally, what we can be talking about is some form of tummy tuck (abdominoplasty), arm lift (brachioplasty), thigh lift, breast lift (mastopexy), and liposuction, and it often is a combination of the procedures.”
“As more people than ever go on Ozempic, surgeons are performing an increasingly larger number of body contouring procedures such as a tummy tuck, a body lift, an arm lift, inner thigh lift, neck lift or facial lifting.”
Where the Devices Stop
Patients ask about the non-surgical options first, and I understand why. Here is where they fit.
“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.”
“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.”
“Patients favor these methods due to their noninvasive nature, which entails zero downtime and no need for anesthesia. They opt for surgical procedures because these interventions yield results that the devices, at present, cannot replicate.”
“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.”
| What you have | What works | What does not |
|---|---|---|
| Small stubborn pockets, skin that still snaps back | Liposuction, cryolipolysis or an energy device, often with Renuvion J-Plasma for the skin | A tummy tuck you do not need |
| Mild laxity, no overhang | Liposuction with Renuvion J-Plasma, Morpheus8 or BodyTite | A freeze or laser alone |
| A true overhang, hanging arms or inner thighs | Tummy tuck, arm lift, thigh lift, often combined | Any device; the skin has to come off |
| Deflated breasts or a hollow face | Breast lift, fat transfer, biostimulators or a facelift | Waiting for the skin to “shrink back” |
Who Is a Candidate, and Who Waits
This is the part Newsweek’s study was really about. Speed of weight loss and complication risk move together, and the fix is not to skip the surgery. The fix is to time 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.”
“Performing surgery too soon often leads to poorer outcomes and an increased risk of complications.”
So the candidate is not the person who has lost the most weight. It is the person whose weight has stopped moving, whose labs and nutrition are in order, who does not smoke, and whose problem is skin rather than fat. If that is you, the surgery is some of the most rewarding work I do. If it is not yet, I will tell you, and I will tell you when to come back.
Why Choose Dr. Agullo
I am certified by the American Board of Plastic Surgery and the American Board of Surgery, completed my plastic surgery fellowship at the Mayo Clinic, and serve as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has listed me as a Top Doctor every year from 2014 through 2026. My practice is heavy in body contouring, and about a third of my consults now involve GLP-1 weight loss. How I plan surgery around the drug is in GLP-1 Patient Surgery Planning, the timing rule is in Body Contouring After Weight Loss, the mother’s version is the GLP-1 mommy makeover, and the men’s version ran yesterday. My commentary on the Newsweek piece is on Dr. WorldWide, and the device side, what the med spa can and cannot do for loose skin, is on Southwest Plastic Surgery.
Ready to Talk?
If the weight has stopped moving and the skin has not, come in and let me look. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
