Face and Body After Weight-Loss Medication — Podcast 1

0:00 — Why plastic surgery after weight loss?

Why do people turn to plastic surgeons after losing weight? Hello and welcome to our channel. Thank you. Doctor, lately everyone is talking about Ozempic, Wegovy and Mounjaro.

People are losing 15, 20 or 30 kilograms. Shouldn't that be the happy ending? Why do they then find themselves at a plastic surgeon's door? Well, losing weight is a wonderful achievement.

People go through a major change in their lives, and they are happy. But the story does not simply end there. A new chapter begins. This time, they contact us to address the loose skin, and a surgical journey begins.

So today, we are not debating whether Ozempic is good or bad. No, that is not our subject today. Ozempic is also an effective and valuable medication. So, we are discussing life after weight loss, not how to lose weight.

Exactly.

1:01 — What does “Ozempic face” mean?

Then let me ask about the phrase everyone knows: “Ozempic face.” Is it really a thing? It is real, but saying it is as dramatic as… No, that is the wrong wording. Let me put it this way: on social media, people like to give things catchy names and make them popular.

“Ozempic face” became one of those terms. Of course, after losing a substantial amount of weight, a person may look in the mirror and suddenly notice sagging cheeks and changes in skin elasticity. The change can look very striking because people are not used to it. A previously fuller face suddenly becomes much slimmer.

So “Ozempic face” became a trending term. But saying the medication damages the face is an oversimplification. It is too simplistic. The medication is not damaging different parts of the body; rather, the changes occur because of the weight loss.

Could we call it volume loss? Yes, there is loss of volume and elasticity. The entire body can develop loose skin. That is why we have recently seen a marked increase in body-contouring procedures.

I have lost 20 kilograms;

2:07 — Timing surgery after weight loss

can I have surgery immediately? We hear this question often. People ask it a great deal, as you know. Can they?

I advise against it, because I do not think surgery is appropriate before a patient reaches a stable final weight. Remaining at a stable weight for at least four to six months also helps the surgical result last over the long term. It is not a matter of saying, “I have lost the weight, so now I am coming in for surgery.” Reaching your target weight does not automatically mean you are ready. It should not be immediate.

Waiting is beneficial. Do we need to wait? And does the skin sag more while we wait? That is somewhat debatable and also depends on what the patient does.

Exercise may provide a small degree of improvement, but suppose your skin has already become loose. If you say, “I am afraid of surgery, so I will wait one or two years and exercise until my skin tightens,” unfortunately that does not happen. Skin does not work that way. Some patients do, of course, try nonsurgical treatments to tighten their skin, and these can provide some improvement.

Exercise may also help the skin recover to a certain degree, but unfortunately it will never achieve the same result as surgery. Now there is also

3:27 — Face: filler, fat grafting or facelift

the face. A patient says, “My face looks hollow.” What should we do: filler, fat grafting or a facelift? Plastic surgery offers many options, both surgical and nonsurgical. But first we need an accurate diagnosis so that we can choose the right treatment.

If the tissues have sagged, the appropriate treatment is a facelift. That may include a facelift, a neck lift, or lifting other areas that have descended. If the problem is volume loss, fat grafting may be appropriate. Some patients do not want fat, so dermal filler may be an option.

Sometimes both approaches are combined: we tighten the skin with a facelift and restore volume to the cheeks and other areas with fat. Simply thinking, “It looks hollow, so let's fill it,” can be risky. Perhaps not dangerous in itself, but everyone asks, “Can you tighten my skin without surgery? Let's put filler here, then do a skin booster, then this and that.” These methods do not work for every patient.

That is my point. We need to assess carefully, make the correct diagnosis, and choose the right combination. Now,

4:37 — Abdomen: liposuction or tummy tuck?

returning to the abdomen: can't we use liposuction and have the skin tighten as well? I have lost 20 kilograms and my abdomen is a little loose. Could we perform liposuction, remove the fat and let the skin retract? In a very young patient, that can sometimes happen.

But generally, that is not the situation. Many patients have already been through pregnancy, followed by weight loss. Since that is our topic, I am focusing on weight loss. Liposuction literally means removing fat.

When we remove the layer of fat beneath skin that is already loose, the skin may sag even more because it no longer has the same underlying support. That usually needs to be corrected surgically. Some patients may also have weakness in the abdominal muscles. That is a separate issue.

In that case, a tummy tuck may be needed, along with repair of the muscle weakness. Liposuction and a tummy tuck are not different sizes of the same operation. One removes fat; the other tightens the abdomen. They are distinct procedures.

However, when performing a tummy tuck, we often add some liposuction, particularly around the waist. Yes, especially the love-handle area; sometimes the back and abdomen are also contoured with liposuction. The goal is to create harmony. That is the whole point.

Of course, we want a more proportionate result. A tummy tuck alone may leave fat around the waist or back. When patients look in the mirror, they naturally want to like what they see. So, a quick question: Is liposuction

6:06 — Is liposuction weight-loss surgery?

weight-loss surgery? No. Liposuction is never a weight-loss operation. Our goal is not to make patients feel better simply about the number on the scale.

It is intended for patients who have exercised for a long time or are already near their healthy weight, to remove stubborn fat and contour the body. It is not a procedure for losing weight. I imagine we will make a separate video about that. Of course.

It is frequently requested, so we will definitely discuss it. Now,

6:43 — Breasts after weight loss

there is also the breast area. The breasts inevitably lose volume after weight loss. Two questions arise: is the issue volume or position? In other words, have the breasts become deflated, or have they sagged?

Volume loss is usually apparent. When you hold the skin, you can feel whether the breast has lost fullness. In those cases, there are not many options for restoring volume. Fat can be transferred, of course, but an implant is often considered.

Some patients, however, still have enough of their own tissue despite the sagging, particularly those with larger breasts. After weight loss, the remaining tissue may be sufficient to reshape and lift the breast using the patient's own tissue instead of an implant. Many prefer that. Is it more natural and sustainable?

Yes, it is more natural and sustainable, and it avoids some of the potential complications of implants. It does not shape the breast exactly like an implant, but there is comfort in knowing that no implant has been placed. Some patients specifically prefer this. Now, there are also the arms and legs.

After

7:50 — Arms, legs and surgical scars

weight loss, if the skin on the arms and legs is loose, can liposuction remove that looseness as well? As we said earlier, these areas are no exception. There are, of course, skin-tightening methods. These are established options, and we use them when appropriate, such as Renuvion or Endolift.

But if the sagging is severe and the patient says, “I truly want slimmer, firmer legs,” then surgery is required. Surgery does leave a scar, but its result is definitive, which is why some patients choose it. So, after weight loss and liposuction, does the loose skin on the arms and legs—and elsewhere—disappear as well? Or what generally happens to the arms and legs after weight loss?

As we just discussed, they are no exception. Like other areas, they can develop loose skin. When that happens, tightening treatments may be considered, and we do use options such as Endolift and Renuvion. However, if a patient wants a truly firm leg, the treatment is surgical.

That comes with a scar, but unfortunately there is no other equivalent method. For genuinely loose skin, the definitive treatment is surgery. Doctor, compared with the past, are scars less of a concern now? There are laser treatments, scar therapies and silicone sheets.

Yes, as you said, silicone sheets, silicone-based treatments and various lasers have become increasingly popular. Medical micropigmentation can also be performed. In some cases, hyperbaric oxygen therapy may help scars improve further. There are even newer peptide products that some patients use.

We sometimes see remarkably good healing in certain patients; the way their scars mature can be very different. In short, as you said, scars seem to be becoming less of a problem than they were in the past. So can we say this: sometimes less treatment is better, but sometimes choosing only a minor procedure is not appropriate? If a lift is needed, we should offer a lift.

Exactly. When a patient truly needs a lifting procedure but you recommend something else, they trust that it will still give them a good result. Later, once they return home, they see that there is some improvement, but not what they expected. When expectations are not met, the patient is naturally unhappy.

Therefore, if a patient wants a sound, lasting result, they will generally accept surgery. When the patient is psychologically prepared, this does not usually create a problem. Now we have come to a difficult question. The patient has lost a great deal of weight;

10:41 — Combining or staging procedures

there is the abdomen, breasts, arms and legs. “Doctor, while I am in Istanbul, why not have everything done at once?” Some patients arrive saying, “I want this, and that,” listing seven or eight different operations. That is not how it works. The patient's medical assessment always comes first.

Even if a patient requests it, we do not proceed if it is not appropriate. For a suitable patient, however, certain procedures can be combined, provided we remain within established medical standards and safety limits. This can produce very satisfying results. The same standards used around the world apply here as well, and we follow them.

The patient's priorities matter too, don't they? Of course. We take the patient's priorities into account. A patient may request six or seven procedures.

In that situation, we divide them into staged operations and ask the patient which goals matter most so we can plan accordingly. The patient tells us, and we create a plan together. We find common ground and agree on the approach. Excellent.

The patient wants to complete everything in one operation, but the surgeon plans to divide them into two stages. Does that mean unnecessary extra surgery is being recommended? As we just discussed, the aim is to balance benefit and risk. If you place too many procedures into one surgical session, complications may occur.

Recovery may also take longer, giving the patient a poor overall experience. Dividing the plan into stages is intended to prevent this and protect the patient; I do not see that as a disadvantage when staging is appropriate. It can also improve the recovery process. Absolutely.

Now, we often overlook this: a person

12:30 — Is the body ready for surgery?

may look ready after weight loss, but is their body biologically ready for surgery? Let's discuss that side as well. The patient's blood tests and metabolic status are very important. After weight loss, for example, a patient may have low iron.

Does that affect treatment? Yes. Low blood levels matter because the blood may not deliver enough oxygen to the tissues. Vitamin D or B vitamins may also be low, and other minerals may be deficient.

All of these need to be at appropriate levels so the patient can heal properly after surgery and tolerate the operation well. This is a process, and the patient needs to understand it. We explain all of this when patients consult us before surgery. We also emphasize that exercise is very important.

Exercise, nutrition, lifestyle and sleep are all part of the picture and must be considered. Let me turn to another subject. Should a GLP-1 medication be stopped before surgery? We also have

13:33 — GLP-1 medication before surgery

a tool on our website that addresses when medications should be stopped. Patients ask about this frequently. Because these medications are generally prescribed by physicians, if a specialist prescribed a medication and it is medically important, I tell the patient to consult the prescribing doctor. Speaking specifically about GLP-1 medications, they are now commonly used for weight loss.

Ideally, the patient has already completed the weight-loss phase and treatment before coming to us. If the medication is being used for diabetes or another medical condition, the prescribing physician's judgment takes priority. As you mentioned, we also have a tool on our website that includes thousands of medications and is supported by scientific evidence. Patients can use it to check which medications may need to be stopped and when.

Dietary supplements are especially relevant, because some can have a blood-thinning effect. We generally ask patients to stop those two weeks beforehand. There is no universal consensus, but that is the usual recommendation. As you said, supplements with blood-thinning properties may increase bleeding.

We advise patients accordingly to reduce bleeding during surgery. Now I am moving on to the rapid-fire questions. Of course. Yes

14:49 — Quick questions

or no? All right. Maybe. Maybe—we will see.

Ready? Here we go. Liposuction causes weight loss. No.

Exercise can eliminate loose skin completely. No, it cannot. I have lost weight, so I can have surgery immediately. No.

The patient needs to wait. Every sagging abdomen requires a tummy tuck. No, not always. In some cases, we can achieve improvement without a full tummy tuck.

More procedures mean a better result. No, that is not true either. Sometimes the opposite happens, and patients may struggle to recover. It is about choosing an appropriate amount of surgery.

Should I have everything that can possibly be done performed in one operation? No, that should not be the goal. Is a natural look the new aesthetic trend of 2026? It appears so.

That is what patients are currently asking us for. Whether it will last, we do not know, but I believe it would be valuable if it did. Of course, some patients want more dramatic results. They may say, “I want very large breasts,” “I want a very prominent buttock,” or ask for a different eyebrow or eye shape.

We perform those procedures too. But overall, I sense a broader movement toward natural-looking results, and the data seem to point that way as well: sustainable and natural. So, to sum up, when do you consider a patient ideal—

16:18 — Readiness and expectations

when do you say, “Now you are ready for surgery”? If we are speaking specifically about weight loss, the patient should have reached their target and maintained a stable weight for about six months. They should also feel physically well and be biologically ready, which needs to be confirmed with laboratory tests. At that point, I consider the patient ready for surgery.

They must also understand what they want. Some patients are undecided, ask many questions or feel very anxious. Psychological readiness matters as well, and it has a significant effect. When all these optimal conditions come together and the patient consults us, if our evaluation shows that everything is in order, surgery can proceed.

So can we move beyond the dilemma of “Change me” versus “Make me look like myself again”? I generally favor, “Make me look like a younger, improved version of myself.” A better version of me. Yes, that is closer to my approach. But as we said earlier, if a patient asks for a transformation, we do not automatically refuse it, provided it remains within reasonable limits.

Safety always comes first; patient safety is far more important to us. We have a planning tool about this on our website,

17:40 — Planning a visit from abroad

but I would also like to discuss it here. How should an international patient plan how long to stay in Istanbul, the final check-up, and when to book the flight? They do not need to plan it alone; we organize it for them. Depending on the operation, we generally recommend staying in Istanbul for five to seven days.

Sibel arranges the hotel, transfers, final and initial check-ups, consultation and hospital admission. We take care of the surgery itself. Another frequent question is: what happens if a patient has a problem after returning home, and how do we proceed? Patients generally receive medical travel insurance.

Before they leave, we take every precaution to prevent problems and complete all necessary checks. This includes follow-up examinations, antibiotics and other medication, and meticulous care during surgery. Usually nothing happens after they return home. If there is a minor wound-healing issue, the patient can generally attend a local healthcare provider through the arrangements covered by their insurance.

If they need to return to Türkiye for treatment by us, we are here and provide every form of support. Our phone line is always open—we simply cannot answer while we are asleep. Otherwise, patients can reach us at any time. I would also like to mention what happens after

19:04 — Drains and massage

the operation, once the patient has been discharged and returned to the hotel. We begin a massage program and use drains. Particularly after liposuction, the first three days are important for removing fluid. What should we tell our patients about this?

I believe a drain is useful after liposuction because a certain amount of fluid inevitably remains inside. A drain allows that fluid to leave the body in a cleaner, more controlled way. It also allows fluid mobilized during massage to collect in a closed reservoir. For that reason, we generally keep the drain in place for two to three days.

Massage is also important. Patients should have at least three or four sessions while they are in Türkiye to help the skin settle smoothly. Think of wrinkled fabric after washing: we iron it to smooth it out. Massage is like ironing the skin.

That is a good analogy. Exactly.

20:10 — Closing

Thank you very much. Thank you for this enjoyable conversation. See you in another episode. I am sure we will, because there is so much more to discuss.

Have a good evening, and keep watching. Good evening. See you next time. Bye-bye.

Bye-bye.