Injectable Weight Loss Medications in Plastic Surgery: What We Know, Perioperative Considerations, and Recommendations for the Future

Abstract

Obesity is a major epidemic plaguing American society. Injectable subcutaneous medications initially designed for use in type 2 diabetes management, such as semaglutide and other glucagon-like peptide-1 receptor agonists, are rapidly gaining popularity for their effects on weight. These drugs (Ozempic, Wegovy, Saxenda, and Mounjaro) are ubiquitous on social media and are promoted by celebrities across all demographics. "Ozempic face" and "Ozempic butt" are now mainstream concepts highlighting the morphologic changes that occur with these medications. There is a paucity of literature available on the impact of these medications for plastic surgeons and their patients. As use becomes widespread, it is important for plastic surgeons to understand their indications, contraindications, appropriate perioperative management, and impact on plastic surgery procedures.

Fig. 1.

Pictorial depiction of the mechanism of action of Ozempic on GLP-1 receptors. Other medications such as Wegovy, Saxenda, and Mounjaro also act on GLP-1 receptors. Up and down arrows represent an increase or decrease, respectively, in the designated end-organ function. GLP-1, glucagon-like peptide-1; HR, heart rate; ANP, atrial natriuretic peptide; GI, gastrointestinal.

Fig. 2.

Example of social media post demonstrating the potential impact of drugs like Ozempic on popular culture and the economy. Credit: Morning Brew, Inc.

Fig. 3.

Contraindications, warnings, and adverse events associated with injectable GLP-1 receptor agonists. MTC, medullary thyroid carcinoma; MEN2, multiple endocrine neoplasia type 2; AKI, acute kidney injury; GI, gastrointestinal.

Fig. 4.

Consensus-based guidance regarding preoperative management of patients on GLP-1 receptor agonists. GLP-1, glucagon-like peptide-1; GI, gastrointestinal.

Fig. 5.

Sequelae of “Ozempic face.”