Ozempic’s Impact on Appearance and Surgical Procedures (Ep 40)

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

Dr. Hall: Ozempic is kind of having its moment in the sun, but there are a couple of things that should be concerning if you’re somebody who’s having surgery. Ozempic, or semaglutide, which is the generic name is a GLP glucagon-like 1 receptor agonist. That means absolutely nothing to you; it doesn’t really mean a whole lot to me. It has to do with how your body handles sugar.

And it’s something that acts like insulin to help clear the sugar in your bloodstream. It’s gotten really popular recently as a weight loss drug. And we have a lot of patients, and I’m sure there are a lot of you out there that are taking Ozempic to lose weight, and I think there’s some considerations when you’re talking about plastic surgery—or just aesthetics in general—that we need to remember. First is that Ozempic causes weight loss and we don’t really know how it works. We know how it clears the the sugar from bloodstream, but we don’t know why people lose weight and lose weight fairly rapidly with Ozempic; the mechanism just isn’t known.

One of the things that we’re seeing in patients is that patients are losing fat fairly rapidly and one of the places that they’re losing fat is in their face. And it is—you know, if you’ve listened to my podcast about facial aging, check that thing out if you haven’t. One of the hallmarks of facial aging is volume loss. And so, we’re seeing patients who are having what is really accelerated facial aging because of the volume loss in their face. I actually have heard this referred to by a couple of people is ‘Ozempic face,’ which I didn’t even know that was a thing.

But that is something you really need to keep in mind, especially if you are somebody who has had or is planning on having fat grafting, for volume replacement because the fat that we move from your body, from your stomach or from your thigh, up to your face is still living tissue. And if you inject the medicine that causes you to lose fat, then you’re going to lose fat in your face that we’ve put there to correct the fat loss that you were having in your face in the first place. And if you’re a patient who has had fat grafting, don’t be surprised if some of the fat goes away if you’re taking Ozempic. That’s kind of the first thing.

The second thing, and this is a mechanism that’s better understood, is that Ozempic slows down the release of food through your GI tract; it slows down your stomach emptying. You think well, okay, you’re full, longer, which is one of the I think one of the ways that Ozempic works to lose weight is that you just don’t feel hungry, but if your stomach doesn’t empty quickly, then that can cause some concern and does cause some concern on my end with anesthesia because we have you—if you’re having surgery, everybody tells you don’t eat after midnight the night before. The reason for that is because we want all of the food out of your stomach, not because it has anything to do with your anesthetic, but it’s a safety measure. What we don’t want you to do is have a full stomach, you get medication that relaxes all of your muscles, and then that stuff comes back up and you end up getting gastric juice in your lungs, which can cause, you know, severe lung irritation called aspiration pneumonitis, it can put people in the ICU. And so, if your stomach is not functioning normally if it’s slowed down because you are taking a medication that slows it down, then we need to be extra careful with our anesthetic.

And so, I’ve started telling my patients that are taking Ozempic that are having surgery that you need to skip those Ozempic shots for the two weeks leading up to your surgery because the Ozempic shot has a half-life of about a week and we want that medication out of your system. We want your GI system functioning normally because with surgery that you want, not surgery that you need, having an aspiration going to sleep for, you know an elective procedure would be a big problem. And so, those are the two things. The fat loss, primarily in your face, and the gastric motility things that we really need to be aware of when we’re talking about patients on Ozempic who are planning on having elective cosmetic surgery or just any facial injections or volume enhancements, now and in the future. Thanks for listening and paying attention. Hope you’ve learned a little something. As always, leave a comment and we’ll be glad to answer any questions that you guys might have.

Dr. Hall: Thanks for listening to The Trillium Show. You can keep up with the latest on the podcast at jhallmd.com. Be sure to follow us on Spotify, Apple Podcasts, or wherever you listen to podcasts. If you want to connect with us on social media, you can find us at @jhallmd on Instagram and Twitter and @DrHallPlasticSurgery on Facebook. Remember, be the change you wish to see in the world.