Growing numbers of people are opting to undergo minimally invasive or surgical procedures to help correct the volume loss and sagging skin that can occur after medication-induced weight loss with GLP-1 injectable drugs.
Here, Patrick J. Byrne, MD, MBA, President of The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and the Enterprise Chief of the Cleveland Clinic Integrated Surgical Institute and Chair of the Head and Neck Surgery Department at the Cleveland Clinic in Ohio, answers five common questions that your patients may ask.

Q: Do patients need to stop taking weight loss drugs before surgery?

A: “Yes. Weight loss drugs cause gastroparesis, or delayed stomach emptying, which increases the risk of aspiration during anesthesia. The current recommendation is to pause these medications three to seven days before surgery to reduce complications, but every surgery is different. You’ll want to discuss this in detail with your surgeon and anesthesiologist. :

Q: I just started taking weight loss medication. Should I postpone my facial plastic surgery?

A: “If you’re planning to lose more than 10-15 pounds, it’s best to wait until your weight is stable before undergoing surgery. Large changes—whether gain or loss—can diminish the longevity of surgical outcomes, particularly for procedures that rely on maintaining soft tissue volume, as well as skin and tissue tension.”

Q: Should I wait until I’m recovered from surgery to restart my GLP-1 medications?

A: “It’s a good idea, especially because these drugs can also contribute to nausea, vomiting, and dehydration, which may slow recovery. If patients are losing weight too rapidly, they might develop nutritional deficiencies, particularly in protein, vitamins, and electrolytes, which could impair wound healing and immune function postoperatively. And for patients managing diabetes, there’s the added risk of hypoglycemia since GLP-1 drugs lower blood sugar. Your doctor will be able to tell you when it’s safe to resume your shots. ”

Q: Are there any procedures patients on weight loss drugs should avoid completely?

A: “I would be cautious about performing facial fat grafting procedures on patients who are still actively losing weight, as their facial fat distribution is still changing. Similarly, minimally invasive skin-tightening treatments may not provide the desired long-term results if significant weight loss continues. For major procedures like facelifts, neck lifts, and blepharoplasty, I strongly recommend ensuring weight stability for at least three to six months before surgery to avoid excessive laxity developing post-procedure. ”

Q: I recently had facial plastic surgery, and I’m about to start taking weight loss medication. How can I maintain my results?

A: “The biggest concern is excessive skin laxity and unpredictable volume loss. When weight loss happens too rapidly, especially in the face, patients may experience a gaunt appearance, deeper wrinkles, and significant sagging in areas like the midface, jowls, and neck. This can make outcomes of facial rejuvenation procedures less predictable and require more aggressive surgical intervention. However, there are many ways to incorporate non-surgical treatments like injectables or skin-tightening procedures to maintain results over time. This is why doctor-patient communication is so key. By combining weight loss strategies with well-timed cosmetic interventions, patients can achieve natural, long-lasting rejuvenation.”