Men using GLP-1s for weight loss: How is this impacting male plastic surgery?

For the longest time, plastic surgery has been associated with women. Technically, the statistics still reinforce this. The 2024 ASPS Procedural Statistics report shows women remain the driving force of the specialty. Interestingly, though, men are slowly starting to catch up. Now, the increasing use of GLP-1 medications in men may be about to shift the industry and push more men to seek sculpting and body contouring procedures.

There is no doubt that GLP-1 medications for weight loss are changing the game in terms of how we view and treat obesity, weight loss and even plastic surgery. The bodily changes associated with rapid weight loss may also help more men feel comfortable pursuing plastic surgery, not just for purely aesthetic reasons.

How are GLP-1s impacting male plastic surgery?

Mommy makeovers, tummy tucks and liposuction once dominated the schedule for Chris Funderburk, MD, with most patients being women. Then GLP-1 medications hit the market.

"You know, we were concerned when the medications began to gain popularity because of how this would affect body contouring plastic surgery," said Dr. Funderburk.

GLP-1 medication use for weight loss would transform the waiting room in his practice.

"I would estimate, so let's say on an average consult day, I see 15 consultations," said Dr. Funderburk. "I would say a lot of days, easily half of them are on one of the medications."

What's more, many of his patients are men.

"About 30 percent of my patients are male patients," said Dr. Funderburk.

Not only are more men seeking plastic surgery, but his practice has experienced a shift.

"So, I would say it's been a complete flip in our practice," said Dr. Funderburk. "I would say that in 2019 and 2020, probably 80 percent of the cases were liposuction, and 20 percent of the cases were your big open skin incision tummy tucks, arm lifts and thigh lifts, you know. And then now that has completely flipped. I would say now it's probably 20 percent are just pure lipo, and then the remainder are all tummy tucks, body lifts, arm lifts, thigh lifts, even the male mastectomy or free nipple grafts."

Why the sudden boom in weight loss, body contouring and lifting procedures? The widely accepted GLP-1 movement is starting to break down barriers. For a time, bariatric surgery was one of the only ways for some individuals to seek dramatic weight loss results. Gastric bypass, sleeve gastrectomy and other surgical procedures helped patients lose weight by changing the size of the stomach or the digestive system. However, there are significant financial and physiological barriers to getting bariatric surgery, making it an out-of-reach option for many patients.

"Fortunately, these medications, to date, have proven to be comparatively low risk," said Dr. Funderburk. "When you think of your bariatric surgeries and not just the cost, but the medical prerequisites to get surgery, then the risk of surgery and the complications could be disastrous. You can get these medications relatively cheaply now, with pretty much access to everyone, and the risk is low comparatively."

Why are more men interested in plastic surgery?

For men and women on GLP-1 medication for weight loss, the biggest hurdle can be coping with the bodily effects of rapid weight loss. Not only can you not choose where the weight comes off, but sometimes the skin doesn't have the elasticity to bounce back. Many patients on weight loss drugs experience loose, sagging skin as a result.

"If you lose a significant amount of weight, you're going to have loose skin," said Dr. Funderburk.

In his experience, some of the top procedures for men are addressing loose skin and sagging with lifts and tucks.

"The number one by far is a lower body lift, so either a circumferential lower body lift or our patients like the term a circumferential tummy tuck, but basically removal of the excess skin along the trunk, basically from the navel down to the pubic hairline and then the removal of that ring of extra tissue all the way," said Dr. Funderburk.

Some patients invest in staged procedures, addressing their most pressing concerns first and then scheduling subsequent surgeries after recovering from the first one to reshape their entire bodies.

"For patient safety, you're breaking things up into more manageable procedures that you can do at a gradual pace," said Dr. Funderburk.

How are men finding out about these procedures and exploring their plastic surgery options? Look no further than your social media feed. You can find ads featuring Charles Barkley and Serena Williams injecting a GLP-1 medication on the subway and on TV. There is also no shortage of influencers online promoting GLP-1 medications and showing off their surgical transformations.

Social media may be a prominent force, but Dr. Funderburk said good old word of mouth also helps to spread the news, adding that many individuals on his staff take weight loss medications and aren't afraid to share their experiences, especially the men.

"I think the men are okay talking about it," said Dr. Funderburk. "Two of our scrub techs are male. They're both open about being on GLP-1 medications. I think it doesn't have the stigma that liposuction had in the past. I think guys are just open to talking about it, and then once they start talking about it, it's just natural that they talk about the loose skin."

What to know before going in

It helps to know what you are getting into before undergoing a body contouring or lifting procedure. These plastic surgery procedures take time, and recovery can be methodical. It's important to consult with a board-certified plastic surgeon to find out what options are best for your body.

First and foremost, patients on GLP-1 medications need to be at or near their goal weight before considering surgical options. Dr. Funderburk recommends that patients work with their primary care physician to guide them toward their ideal healthy weight before moving forward with plastic surgery. Patients who are still actively losing weight may not get the benefits and aesthetic results they want from a premature lift or other contouring procedure. Patients also risk needing future surgeries to address additional loose skin or tissue. These surgeries can be more complicated due to scar tissue and other factors. Revisions are simply more challenging.

Patients must also be prepared to stop taking their medication for an extended period.

"Someone should be off GLP-1 medications for at least two weeks prior to surgery," said Josef Hadeed, MD, FACS.

Dr. Funderburk recommends that his patients stop taking the drug for at least six weeks, three weeks before surgery and three weeks after. GLP-1 medications and anesthesia do not mix.

"One of the primary ways these medications work is by delaying gastric emptying so you feel full sooner," said Dr. Funderburk. "The issue is, traditionally, with surgery, we're counting on normal gastric emptying for the stomach to be empty at the time of surgery. We're used to someone not eating or drinking after midnight the night before surgery and then assuming that their stomach would be empty. What we've seen with these medications is that oftentimes the stomach is not empty, and then they're at risk for aspiration."

Aspiration is a significant complication where a patient inhales stomach contents into the lungs. Severe cases of the condition can lead to long-term complications and potentially death.

Men need to recover slowly and easily following a significant plastic surgery procedure. Recovery can take six to eight weeks or more, depending on the type and extent of the surgery. Male patients should avoid heavy lifting and strenuous exercise and may need some extra time off work if their career involves strenuous activities or manual labor.

Patients interested in multiple procedures must work with their plastic surgeon to plan their skin removal journey, focusing on the areas they want to address first. For patients requiring multiple lifts or procedures, Dr. Funderburk recommends spacing them at least three months apart.

It's not all about "the look"

Men may be having more open conversations about weight loss, plastic surgery and loose skin, but the core reasons behind why they are getting these procedures aren't strictly aesthetic. Yes, contouring and lifting procedures help eliminate excess skin, giving the body a tighter, more toned appearance, but these procedures offer something more – mobility and a healthier lifestyle.

Loose or sagging skin can impair mobility and functionality, preventing men from achieving weight loss and health goals. Excess skin can cause pain when walking, lifting or exercising due to chafing and rubbing. Not only can it inhibit fitness goals, but it can also make daily tasks frustrating. Loose skin is also more prone to infections, sores and rashes, which can be painful and uncomfortable. Left untreated, these wounds can also cause significant health concerns.

When discussing the end result of a lift, one aspect can't be ignored or hidden – the scarring.

"I think that the biggest concern that patients have with these surgeries going in is the scarring because each of them leaves a lengthy scar," said Dr. Funderburk. "The amount of skin we can remove really is dictated by the length of the scar, and with many of these surgeries, we're talking about scars that go all the way around the body. There are more prominent regions like the chest, along the arms, the thighs, things that you can't just hide, like your typical breast surgery or tummy tuck. What I've been surprised by is that in the long term, there are almost no patients. I mean, almost none actually complain about the scar. They're so relieved to have all of that excess skin removed that they couldn't care less about the scar."

Dr. Funderburk also informs patients that there are ways to mitigate the appearance of scars, such as scar modulation therapies like medical-type tattooing, laser therapy and microneedling.

Weight loss medications and plastic surgery are not just about a man's appearance. They're about how he feels. This new arena is giving more men the okay to be confident, fit, healthy and happy in their own skin... just less of it.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.