Introduction: More so even than bariatric assisted weight loss, the emergence of GLP-1 RAs (e.g.
Ozempic) as a new paradigm in diabetes and weight management has already impacted my
clinical demographic. Both plastic surgery and GLP are powerful catalysts for personal
transformation. A closer look reveals an inevitable interplay between the two, both with potential
to empower individuals to embrace a healthier and more confident version of themselves.
Plastic Surgery: A gateway to self-confidence, it’s not about fat-shaming Plastic surgery has long
been a vehicle for individuals seeking to enhance their physical appearance and, in turn, boost
their self-esteem. Rather than the traditional perception that plastic surgery aims only to achieve
aesthetic goals in isolation, in the context of newly achieved weight loss, recontouring loose and
saggy skin excess (abdominoplasty, tummy tuck) or reshaping deflated breast tissue (breast lift,
mastopexy, auto-augmentation) may not only have a profound impact on an individual’s
confidence and mental well-being, but enable further holistic improvements in a patient’s
lifestyle; such as the ability to exercise freely. I have found these patients to be seeking to regain
confidence in their appearance, aligning with their new and broader health goals.
There are cautionary tales, however, which I have noticed in my own patient cohort and must be
considered during the planning of procedures, both to optimise safety and the long term result.
From an anaesthetic perspective, delayed or slowed gastric emptying may increase the risk of
aspiration of contents during surgery and most recent advice is to stop at least a week before
surgery. Diabetes management may have to be reviewed for this brief period. Immediately
following surgery, any GLP-1 RAs or anaesthesia-related nausea may be compounded and it is
important to be ready with smaller nourishing meals that whet the appetite! I will also anticipate
this where possible and take care to reduce and avoid provocative painkillers. Finally, evidence
is emerging that GLP-1 RAs may be required for long term weight stability even when the goal
weight is reached. I would encourage that this is discussed with the prescribing physician prior to
considering surgery such that your long term result is not compromised by weight rebound.
Whether it’s through the hands of an experienced plastic surgeon or the therapeutic benefits of
medications like GLP-1 RAs, the synergy between these two realms offers a pathway for
individuals to not only look their best but also feel their best from the inside out. Ultimately, the
goal is to empower individuals to embrace their unique journey towards self-confidence and a
healthier, more fulfilling life.