(Bloomberg): Jennifer Witherspoon, 47, of Austin, Texas, can’t stop sharing photos of her new body. After losing more than 100 pounds on weight-loss drugs, she had a tummy tuck and breast lift to remove loose skin, and now she’s showing off her washboard abs in a bikini for the first time in 20 years.

“I’m literally living my best life,” he said.

Patients taking new obesity drugs such as Ugobi and Zepbound are finding that after losing 50 kilos, they have loose skin on their stomachs, arms and buttocks. Loss of elasticity in the face and breasts can make them look much older than their real age and give them the haggard look known as “Ozempic face.”

This is a gold mine for plastic surgeons.

Facelift procedures are up 8% from 2022 to 2023, driven by demand likely driven by people getting weight-loss injections, according to a report released on the 25th by the American Society of Plastic Surgeons (ASPS). The society represents 92% of plastic surgeons in the U.S. Tummy tucks and lower body lifts increased 5%, the report said. Arm, thigh and breast lifts also increased.

ASPS President Stephen Williams said patients “can all have cosmetic concerns” after losing weight.

The number of patients taking obesity medications is expected to increase as more options become available. For example, Eli Lilly’s Zepbound was only released in December, and there are likely many patients who were not included in the ASPS report.

As an estimated millions of people taking GLP-1 receptor agonists from Eli Lilly and Novo Nordisk, or copycat drugs from Hims & Hers Health and other companies, start considering plastic surgery, doctors are confronted with an ethical question: What happens if those patients keep losing weight or regain it?

Clearly, many of the people who shell out more than $1,000 a month for weight-loss drugs are also prepared to spend money on tweaking their bodies after they’ve lost the pounds. Few of these plastic surgeries are covered by insurance, and experts say a full body procedure can cost more than $80,000.

“It’s a whole new type of patient,” said Michelle Shermak, an ASPS member and plastic surgeon who specializes in body contouring, noting that about 20 percent of her patients in her Baltimore clinic are taking weight-loss drugs. “We’re all excited to get back to being a size 8,” she said.

The GLP-1 boom is not only benefiting plastic surgeons, it’s also driving business for medical spas offering services like anti-wrinkle Botox and fillers. Botox and similar injections grew 9 percent in 2023, while fillers grew 8 percent, according to the ASPS report. For some patients, these non-invasive options and exercises work. But for those who have lost a lot of weight, plastic surgery may be the only way to tighten loose skin.

“You can’t put pants in the dryer to shorten them, you can only hem them. It’s the same with excess skin. Plastic surgery is the only way to deal with it,” said Alan Matarasso, a New York City plastic surgeon.

Alison Rose, 45, lost a total of 148 pounds with the commonly used type 2 diabetes drugs Ozempic and Monjaro. The Missouri resident was left with loose folds of skin around her torso that repeatedly became infected. Even though she’d lost nearly a third of her body weight, her clothes didn’t fit around her waist. The area was always sweaty and raw, and she smelled bad no matter how many showers she took throughout the day.

He underwent a procedure called a panniculectomy in March, and surgeons ended up removing six pounds of skin and tissue, he said.

Insurers may cover a panniculectomy called an “apron tuck,” which removes loose skin from the lower abdomen. The procedure is sometimes deemed medically necessary. In contrast, a “tummy tuck,” which is often performed on women after pregnancy, involves suctioning out fat to tighten abdominal muscles and is considered more of a cosmetic choice, so it’s not usually covered.

Rose also had a breast reduction and lift, and says all the procedures were “absolutely” worth it. “Now I’m not in pain all the time,” she said.

Matarasso says he’s seen the number of patients who have used weight-loss injections double in the past year. But it’s not the first time he’s seen a new weight-loss treatment bring in a wave of new clients. Twenty years ago, he noticed a rise in “bariatric surgery,” in which patients lost significant amounts of weight after undergoing procedures to reduce the size of their stomachs and intestines and limit how much food they consume and absorb.

Studies of early groups of such weight loss patients generally showed that the health and self-confidence of weight loss patients improved after plastic surgery to remove excess skin.

But some patients may have unrealistic expectations about the final outcome, says Jane Ogden, a professor of health psychology at the University of Surrey, who surveyed patients for the study.

“The end result is not always the body they had in mind,” says Prof Ogden, adding that scarring can be an issue, there can be lingering self-esteem issues and patients who regain weight after undergoing cosmetic surgery express regret and concern that they have “taken the wrong journey”.

Original title: Wegovy Users Drop $80,000 on Plastic Surgery for Flabby Skin (3) (excerpt)

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