Weight-loss drugs may be leading to an increase in plastic surgeries

According to the report, which analyzed patient data from over 1,600 plastic surgeons, dermatologists, and otolaryngologists, there was a 5% increase in plastic surgeries and a 7% increase in minimally invasive procedures between 2022 and 2023.

Two of the most popular procedures were facial and neck surgeries, such as facelifts, neck lifts, forehead lifts, and submental (or chin) liposuctions. All these procedures increased in 2023 even though some saw a decline in 2022.

Abdominoplasties (or tummy tucks) and lower body lifts also saw a 5% increase in 2023. Arm lifts, thigh lifts, and breast lifts were also higher in 2023 compared to 2022.

There were also increases in minimally invasive cosmetic procedures, such as neuromodulator injections (Botox, Dysport, Xeomin, and Jeuveau) and hyaluronic acid, or dermal, fillers. In 2023, there were 9.5 million neuromodulator injection procedures and 5.3 million hyaluronic acid filler procedures.

According to the report, this increase in procedures may be due to the growing trend of GLP-1 drugs, such as Ozempic and Zepbound, being used for weight loss. Rapid weight loss from the drugs can lead to skin elasticity to decrease, which can lead to loose or sagging skin.

After losing weight on GLP-1 drugs, "all of those people potentially are going to have issues with how they look afterwards," said ASPS president Steven Williams.

"You can't put pants in the dryer to make them shorter, the only way to do that is to hem them,” said Alan Matarasso, a plastic surgeon based on New York City's Upper East Side. The same is also true with excess skin. "Plastic surgery is the only way to address that."

Do doctors need to be more cautious with patients using weight-loss drugs?

Currently, research on patients who received bariatric surgery shows that plastic surgery to remove excess skin after weight loss improves patients' health and confidence. However, Jane Ogden, a professor of health psychology at the University of Surrey, said that some patients may have unrealistic expectations about the end results of surgery.

"The body at the end isn't necessarily the body they thought they were going to get," Ogden said, noting the scarring or lingering self-esteem issues may be problems. Patients who regain weight after plastic surgery also express regrets and concerns of "being on the wrong journey," she said.

According to a study published last year, it's common for patients to gain back some of their weight after undergoing body contouring plastic surgery.

In the study, researchers followed 121 patients who had surgery to remove skin folds and fat, and half who previously had bariatric surgery. Those who had received bariatric surgery saw their weight increase by an average of 12% from their lowest points, while those who didn't have bariatric surgery regained an average of 7.6% of their weight.

A separate study from 2011 also found that some of the weight that patients regain may end up in other parts of their body, at least for those who also get liposuction. Once fat cells are removed in one area, the body will look for other areas to store it, meaning that liposuction on the thighs could lead to fat moving to the arms.

Because of these issues, some doctors are being more cautious about how they treat patients using weight-loss drugs. "We don't have a crystal ball, and anyone we operate on could potentially gain or lose weight in the future," said Nora Nugent, vice president of the British Association of Aesthetic Plastic Surgeons. "We would want to be reasonably certain that someone's at a steady rate before undertaking this surgery."

Advisory Board's weight-related resources

According to CDC data, more than 70% of U.S. adults ages 20 and older are either overweight or obese. Obesity is also prevalent  among children, with rates growing between 17.7% and 21.5% over the last decade.

As obesity rates continue to rise, so will healthcare costs. Currently, obesity costs the U.S. healthcare system $173 billion every year.  

To help address the growing weight-related issues in healthcare, Advisory Board offers several resources on different topics, including:

GLP-1 drugs

Interest in new weight-loss drugs, including Novo Nordisk's Wegovy and Eli Lilly's recently approved Zepbound, has surged this year, leading to record sales — as well as supply shortages as manufacturers struggle to keep up with demand.

Advisory Board's Chloe Bakst and Rachael Peroutky  recently shared their insights on how GLP-1 shortages might impact healthcare and what leaders can do in the meantime.

Radio Advisory's Rachel Woods has also covered GLP-1 drugs on the podcast, discussing the  potential future of these drugs  and how they could help — or hurt —  health systems' finances.

Other useful resources include the expert insights  "5 catalysts that will impact the future of weight management drugs,"  and  "What the headlines get wrong about weight management medications."

Bariatric surgery

In 2022, the American Society for Metabolic and Bariatric Surgery and the International Federation for the Surgery of Obesity and Metabolic Disorders updated guidelines for weight-loss surgery, expanding eligibility for more people.

Under the new guidelines, anyone with a BMI over 35, regardless of their health status, is eligible for weight loss surgery. People with a BMI over 30, which is the official definition of obesity, are also eligible if they haven't been able to achieve substantial or long-term weight loss.

This expert insight outlines three barriers to bariatric surgery and how to overcome them. For patients considering bariatric surgery, this resource offers three factors they should keep in mind while they decide.

Meanwhile, this decision guide offers resources to help you build a successful weight management program that effectively attracts new patients struggling with obesity. It also guides patients through their care journey and keeps them engaged in the long term.

Healthcare's approach to obesity

Recently, healthcare organizations have made an effort to move away from using BMI to determine obesity and assess health. In June, the American Medical Association voted to adopt a new policy that moves away from using BMI alone when assessing whether a patient is at a healthy weight.

Some physicians are also looking beyond BMI and people's weight as they assess their health and recommend treatments. Instead of focusing on weight loss to treat health issues, some providers are now taking a "weight-neutral" approach that avoids intentional weight loss.

In a recent Radio Advisory episode, Rachel Woods and Advisory Board experts Darby Sullivan and Chloe Bakst discussed healthcare's current approach to obesity and whether it's helping or harming patients.

Similarly, this expert insight covers three missteps in our current approach to obesity, outlining five potential ways providers can address these issues. (Muller et al., Bloomberg, 6/25; Johnson, Forbes, 6/25)