Effects of GLP-1 receptor agonists on aesthetic surgery practice: A contemporary review.

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become increasingly relevant to aesthetic surgery because of the significant weight loss they provide in the treatment of type 2 diabetes mellitus and obesity. While these agents expand the pool of surgical candidates, they also raise new clinical questions related to rapid or substantial weight loss, including soft tissue volume loss, skin laxity, nutritional deficiencies, perioperative safety concerns, and the durability of aesthetic surgical outcomes. This contemporary narrative review evaluated the current implications of GLP-1 RAs in aesthetic plastic surgery practice. A targeted PubMed/MEDLINE search covering January 2015 through August 2026 was supplemented by manual reference screening. Retrospective cohorts, database analyses, prospective observational studies, systematic reviews, survey studies, case reports, and selected guidance or opinion articles were evaluated. Current literature indicates increasing demand for facial aesthetic, breast aesthetic, and body contouring procedures among patients using GLP-1 RAs. The facial volume loss and skin laxity popularly described as "Ozempic face" more plausibly reflect rapid or substantial weight loss than a proven drug-specific facial effect. Although the breast surgery literature remains limited, upper-pole volume loss, ptosis, reduced soft tissue support, and healing problems along high-tension closure lines are noteworthy. Outcomes in body contouring surgery are heterogeneous: While some studies report comparable complication rates, others emphasize delayed wound healing, wound dehiscence, altered scar behavior, or nutrition-related risks. Surgical timing, weight stabilization, nutritional balance, and individualized perioperative aspiration-risk assessment are key areas of evaluation. GLP-1 RA use should be considered neither an absolute advantage nor an automatic contraindication in aesthetic surgery. Direct pharmacologic effects often cannot be separated from the consequences of weight loss or baseline metabolic risk. Surgical decision-making should be individualized based on weight stability, metabolic optimization, nutritional status, history of bariatric surgery, psychological adaptation, and procedure-specific risks. Current evidence is promising but heterogeneous, and prospective studies are needed to clarify long-term aesthetic outcomes and procedure-specific risks.