What’s Changed in Breast Surgery in the GLP-1 Era?

It’s not just body contouring or skin tightening that’s having a moment in the wake of GLP-1 medications like semaglutide and tirzepatide. Breast surgery is becoming a go-to next step after weight loss, too. With more patients dropping weight quickly and at younger ages, plastic surgeons are adapting their approach to better match what this new generation of weight loss looks like.

Featured Experts

• Dr. Joseph Russo is a board-certified plastic surgeon in Newton Centre, MA
• Dr. David Turer is a board-certified plastic surgeon in Pittsburgh 
• Dr. Sean Arredondo is a board-eligible plastic surgeon in Austin, TX 

Newton Centre, MA plastic surgeon Joseph Russo, MD says that while the weight loss is real, it’s not always extreme. “People are losing 10 to 15 percent of their body weight, which is a fairly good amount, but it’s usually not enough that they come in needing surgery,” he says. “If it’s a slow or gradual loss, the skin has a chance to contract. That’s very different from what we see with post-bariatric patients.”

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Rather than requesting full body lifts or major overhauls, many of today’s GLP-1 patients are walking in with smaller, more focused concerns. One area that is seeing more attention? Lifts and revisions.

More Revisions and Lifts

Breast procedures are on the upswing. Since 2019, breast lift surgeries have increased by 54 percent, according to the American Society of Plastic Surgeons. Breast reductions are also becoming more common, and overall, breast-related cosmetic procedures, including lifts and revisions, have gone up by 15 percent. One area getting more attention is revision surgery. “I think one of the things I saw a lot in New Jersey, and I continue to see a lot of now, is revision breast surgery,” says Pittsburgh plastic surgeon David Turer, MD. For patients who’ve had implants in the past or are noticing volume shifts after weight loss, it’s often about refining or reworking what’s already there.

A Rise in Auto Augmentation

When the concern is deflation or loose skin but the patient doesn’t want implants, auto augmentation is becoming a go-to solution. “Auto augmentation is a technique that uses existing breast tissue to enhance the shape and size of the breasts,” explains Austin, TX plastic surgeon Sean Arredondo, MD. “It’s ideal for patients who’ve lost weight and want a lifted, fuller look without adding anything foreign to their body.”

A New Safety Consideration

Dr. Russo adds that any patient currently on a GLP-1 should be prepared to pause the medication before surgery. “If someone is interested in doing surgery and they’re on GLPs, they have to stop for a couple of weeks beforehand,” he says. “These drugs slow down gastric emptying, which puts patients at risk for vomiting while under anesthesia. That can lead to aspiration, which is a dangerous situation.”

A Younger Patient Population with Different Needs

Unlike the typical post-weight loss patient of the past, many of today’s patients are younger and earlier in their body journey. “What I’ve noticed is that the people coming in are younger because they’re not 40 or 50 after having bariatric surgery,” says Dr. Arredondo. “They’re 20 or 30 after losing 40 pounds. They might still want to have kids later, or they’re just busy professionals who can’t take the downtime. So, we’re having different conversations about what’s worth doing now versus later.”

As the experts are seeing, for many GLP-1 patients it’s less about dramatic makeovers and more about restoring what’s changed, refining what’s left, and making choices that fit their life now. That’s where breast surgery is going.