The popularity of GLP-1s has led many people to achieve significant weight loss. While this can provide substantial health benefits, some people are left with excess skin that does not fully retract. In these circumstances, Body Contouring surgery may be considered.
It’s important to wait before jumping into surgery, though. And, if you are still on GLP-1s, you must follow a couple of simple but specific precautions before your operation. This article covers what you need to know.
Why Won’t My Skin Tighten After Weight Loss?
When your skin is significantly stretched during weight gain, the collagen and elastin within your dermis can become stretched and structurally altered. Then, after losing significant weight, the skin that has lost some of its elasticity may not fully retract to fit your smaller underlying body contour. This can leave you with permanent folds of loose skin and, in some cases, stretch marks.
Once significant, permanent excess skin has developed, creams, exercise and non-surgical treatments cannot remove the excess skin. Body Contouring surgery, however, aims to remove it definitively.
Some people are affected more by loose skin than others, however. Various factors come into play, such as your age, genetics, the amount and speed of weight loss, how long your skin was stretched, sun exposure, and your skin’s natural elasticity, which can all influence the final amount of loose skin.
It’s likely that you’ll have loose skin in more than one area, though. For example, it’s common after massive weight loss for patients to be left with loose skin in the abdomen, back, upper arms, thighs and buttocks. Some of these areas may not cause much concern. In contrast, others may cause issues such as skin irritation, chafing, infections, and functional problems like an inability to exercise or wear certain clothes. In these instances, Body Contouring surgery may be considered.
Is Weight Loss From GLP-1s Different from Other Methods?
Weight loss from GLP-1 receptor agonists is not fundamentally different from other methods of rapid weight loss when it comes to muscle loss.
Roughly 20% to 40% of total weight lost through GLP-1s comes from lean mass (which includes muscle). This proportion is very similar to traditional diet-induced calorie restriction or bariatric surgery.
When taking GLP-1s, your body experiences:
- Calorie and protein deficit: GLP-1s heavily suppress appetite, which often leads to a drop in daily protein intake.
- Rapid scale drop: Fast overall weight reduction naturally forces the body to shed a mix of both fat and supportive lean tissue.
- Reduced physical load: With a lighter body, you carry less total body mass, reducing the baseline mechanical load on your body, slightly lowering your body’s stimulus for muscle maintenance.
It’s important to understand that your muscle loss when on GLP-1s is caused by the reasons above, not by the medication itself. GLP-1s do not possess a unique biological mechanism that actively targets or wastes skeletal muscle tissue. Instead, the effect is driven by the energy deficit itself, much like any other diet and exercise regimen.
Why You Should Wait Before Surgery
The temptation to proceed straight to Body Contouring surgery once you know your skin laxity is permanent is understandable. However, Dr Dona recommends maintaining a stable, sustainable weight for at least six months before considering Body Contouring surgery. This is for two vital reasons.
Stabilise your weight: Use this time to ensure you can maintain this weight, as further weight fluctuations can compromise your results. For example, if you continue to lose more weight after surgery, you will likely end up with more loose skin and less optimal results from the procedure. Also, there is no specific weight you must reach before surgery. What matters is reaching a weight that is sustainable for you.
Optimise your health: When your body is in a significant calorie deficit, it has a reduced healing capacity, slower post-operative recovery, and a final contour that may differ from your expectations.
During active or rapid weight loss, it can be difficult to meet your body’s nutritional and protein requirements consistently. Adequate nutrition is particularly important before surgery because your body requires sufficient energy, protein, vitamins and minerals for wound healing and recovery. This is another reason it is best to let your weight stabilise and ensure you are nutritionally well before undergoing Body Contouring surgery.
Optimise Your Wait Time
Waiting three to six months for your surgery needn’t be a boring time. Instead, consider it an opportunity to supercharge your health and increase your chances of an optimal surgical result. There are various things you can do.
Optimise your diet – Ensure you eat adequate amounts of protein, fats, colourful fruit and vegetables, high-fibre whole grains and drink plenty of water.
Increase muscle tone – You would have lost muscle tissue during your weight loss journey, so it’s important to eat enough protein and perform weight training exercises to maintain or rebuild your muscle strength.
Get enough sleep – Adequate sleep supports general health and recovery and can help you feel physically prepared for your surgery.
Current Guidance Regarding GLP-1s Before Surgery
As you get closer to your Body Contouring surgery date, there are a few things you need to know about taking your GLP-1s. First, when undergoing surgery with Dr Dona, you will generally not be required to stop your GLP-1 medication. Instead, you will need to follow specific preoperative fasting instructions. This will help ensure your safety and minimise the risk of complications during anaesthesia.
These typically include following a 24-hour clear fluid diet before your procedure, then fasting from all food and fluids for 6 hours, as instructed by your surgical and anaesthetic team.
Your anaesthetist and surgical team will provide your individual fasting instructions, which you must follow even if they differ from general advice you have read elsewhere.
This approach minimises the risk of retained gastric contents, which can lead to complications under general anaesthesia. Dr Dona will discuss these with you thoroughly in the weeks leading up to your procedure.
Book a Consultation with Dr Dona
If you’d like to discuss Body Contouring surgery, the first step is to book an appointment with Dr Eddy Dona in his Sydney-based rooms.
During your appointment, you can discuss your objectives, have Dr Dona thoroughly examine you and review your medical history.
If he determines that Body Contouring surgery may be considered, he will explain the options, the surgical approach, outline the expected recovery and discuss potential risks and complications. He will also take the time to answer any questions you have, so you feel fully informed before making any decisions.
