October 06, 2026 | Recovery, Semaglutide, Skin Care Regimen
“You’re pretty honest about the topicals: it’s not going to remove the excess skin. But we have to do everything we can to make the process the best possible and to try to minimize how much surgery we’re going to need.”
Marc McKee lost 126 pounds and asked me about skincare on his podcast, This Is My Journey. That was my answer. Then I told him my surgery patients get a moisturizer too, and that one surprised him.
What a GLP-1 Does to Skin Before the Weight Is Even Off
“Topicals definitely have a place in weight loss. We’re having less fat consumption, and fat is an emollient that helps with barriers in the cell membranes. We’re taking less protein, which generates collagen. And we’re usually taking a lot less fluid, so we’re dehydrated. All three decrease the moisture in the skin, which makes it look older a lot quicker.”
“As we’re losing weight, the first thing patients notice is the face, usually at two months.”
More on that in the face after weight loss post and on the Ozempic face page.
What a Cream Can Do
“The topicals have two functions: barrier and attracting moisture, and then the antioxidants, which keep the skin looking younger, and retinoids, which can speed up turnover. So the skincare helps with fine lines and wrinkles, makes the skin appear firmer, helps with texture, helps with comfort, because with weight loss we also have problems with dry skin and itchiness.”
The med spa side of this is in the full post on swplasticsurgery.com. This one is about surgery.
Why Surgery Gets the Same Treatment
“Skincare is part of any surgery I do. Even for a breast augmentation or a tummy tuck, I put my patients on a special moisturizer, because when there’s inflammation and recovery you lose that moisture, and that really hurts you in the end.”
So it’s in the surgical package, with the garments, the scar cream and the supplements. The full list is on the fees page.
| Situation | What strips moisture | What I do about it |
|---|---|---|
| GLP-1 weight loss | Less dietary fat, less protein, less fluid | Topicals from day one, protein, water |
| Post-surgical recovery | Inflammation and healing | Moisturizer in the surgical package, scar cream |
| Both together (weight loss, then surgery) | All of the above, in sequence | Skin cared for through the loss, then through the recovery |
Where Topicals Stop and I Take Over
“I would start with the topicals early on to give the skin the foundation and help it recoil as much as possible.”
“If you’re losing 40 pounds, I think you’re going to need a surgical procedure. It depends: some people care about the face, some about the buttocks, so it’s very personal what gives the patient the self-confidence.”
And if you just wait?
“It’s hard to tell. Younger patients are going to retract better. Everybody retracts some, probably not as much as we would want, and it’s also sooner than people think. It really happens in the early stages, and I think at a maximum of a year it’s all done.”
“Skin stops producing elastin after puberty, so it just doesn’t contract like it does during puberty.”
After that it’s a tummy tuck, a lift or a body lift. On timing:
“What I’ve been seeing is about a six to nine month weight loss and then about a three month stabilization until we’re ready for surgery.”
More in the body contouring after weight loss post.
Who Should Be Doing This
Anyone on a GLP-1, from the first week. Anyone losing weight after bariatric surgery. Anyone with surgery booked with me.
“It depends on the amount of weight you lose, how fast you do it, and how you take care of yourself during that time. Are you taking protein? Are you doing weightlifting and building muscle?”
The Misconception: The Cream Is the Fix
It isn’t. For WOWMD I said read the active ingredients, not the front of the jar, and expect subtle results after eight to twelve weeks.
“The skin is going to react the way it does. We can’t do a lot about it. We can help it in some ways, but you shouldn’t feel bad if you have excess skin. It’s part of losing weight, and everybody’s different.”
Why Choose Dr. Agullo
Board certified in plastic surgery and general surgery. Mayo Clinic fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech. Castle Connolly Top Doctor 2014 through 2026. I prescribe the GLP-1, I treat the skin, and I do the surgery. “The reason I started doing this social media was to educate patients. Education and knowledge is power, and it gives you more options as you go through life and this journey.”
The rest of the podcast is in the earlier post.
Ready to Talk?
Bring your skincare and your weight loss timeline to the consult. Both change the plan.
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.
