October 15, 2026 | Body Contouring, Face, Weight Loss Surgery
“About 30 percent of my patients involve a patient who has lost weight on GLP-1s. Before the GLP-1 era, my post-bariatric weight loss surgery practice was about 10 percent.”
That is my practice today. One in three. The wider picture, what these patients book and where demand is going, is in the full post on the Southwest Plastic Surgery site. This one is about the surgery itself.
The Operation They Ask For First
I expected the tummy tuck to lead. It does not.
“The most common procedure after GLP-1 weight loss right now is a deep plane facelift, a deep neck lift, and/or an endoscopic deep plane facelift, also known as the ponytail lift. This is surprising, because in the post-bariatric patients the most common procedure was a lower body lift, which addressed the abdomen, the buttock and the thighs.”
I wrote about why the face goes first in the face after weight loss post. The body side lives on the body contouring after major weight loss page.
What Is Different in My Operating Room
“For a massive weight loss patient, the traditional tummy tuck or breast lift or buttock lift may take a little bit longer, maybe an hour, because there is a lot more skin and tissue to be removed versus a patient that has not lost weight. Of course, more time in the OR and anesthesia can increase the overall cost of the surgery. The difference is usually going to be in the two to three thousand dollar range.”
More skin. More tissue. About an hour. The fees page carries the starting numbers, and this is one of the things that moves a case above them.
Volume Still Has to Go Back
“Augmentation-type work is still really untouched, because the weight loss patients also need augmentation of lost volume in the breast, buttock and face, whether it’s with implants or fat grafting.”
“My BBL volume has not dropped in my practice. It’s still an essential part of almost every mommy makeover in order to shape the hip area and buttock area. We’ve seen a transition to less volume and more natural silhouettes, but it’s still in very high demand.”
Weight loss takes fat from everywhere, including the places that looked good with it. The mommy makeover in a GLP-1 patient is usually a lift plus a fat transfer, not a lift alone.
One Session or Two
“Combining surgeries is very common in my practice, and of course safety is the number one priority. The surgery length has to be predetermined to be safe, usually under six to eight hours. Depending on the complexity and invasiveness of the procedures, an overnight stay and blood products on standby might be necessary.”
That is the ceiling. Inside it, combining is the better deal.
“Combining multiple procedures does have its advantages, because the patient only has to recover once and take time off work once. It also has an economic advantage, because the first hour of surgery is the most expensive. That first hour is the one that pays for all the supplies, the medications, the preoperative time. So there is a cost savings component to it.”
| Two separate surgeries | One combined surgery |
|---|---|
| Two recoveries | One recovery |
| Two blocks of time off work | One |
| Two “first hours” of setup cost | One |
| Each case shorter | Total capped at six to eight hours for safety |
The Two-Week Rule
“Our practice really hasn’t changed because of the increase in GLP-1 weight loss patients. We still do our complete workup and consultation prior to surgery. The financing is done in the same terms. I think the most important thing with GLP-1 patients is to stop the GLP-1 medication two weeks prior to surgery. Otherwise, it’s like any other patient, with the same high-grade attention to detail.”
Two weeks. Same workup as everyone else. The timing post covers the rest of the calendar.
Stable Weight First
“The most important thing is for the patient to be stable at their weight. If they continue to lose, or go up and down, they may need more procedures in the future.”
I would rather operate once. So would you.
Where This Is Going
“As the cost of GLP-1s has decreased, I’ve seen more patients on GLP-1s, more patients successfully losing weight and getting toward their ideal weight, and an increase in patients seeking correction of the loose skin and loss of volume. I foresee a continued increase in demand for these surgeries.”
The next compound, retatrutide, will add to that. The complete Q&A, including my read on restoration versus transformation, is on the Southwest Plastic Surgery site.
Why Choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026. Roughly one in three of his consults is now a patient after GLP-1 weight loss.
Ready to Talk?
Bring your weight history and your medication schedule. We plan the surgery date around both.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
