More and more patients come to consultation using Ozempic, Wegovy, Mounjaro or other medications in the GLP-1 family. They’re useful tools, but there are several things to consider before surgery.
Why does Ozempic matter for anesthesia?
These medications slow down how fast the stomach empties. Under general anesthesia, the stomach may still contain food even if you fasted, and there’s a risk that content comes up and enters the lungs. It’s a serious complication, and it can be prevented.
Do you need to stop it? What the guidelines say and what I do
In 2024, the American Society of Anesthesiologists and other societies published guidance stating that many patients can continue the medication, and that higher-risk patients should follow a liquid diet for 24 hours before surgery. They also advise against operating during the dose-escalation phase or while there’s nausea or vomiting.
In my practice, because this is elective cosmetic surgery, I’m more conservative: I prefer to pause it at least three weeks before. We always coordinate with the doctor who prescribes it, especially if you use it for diabetes.
Ozempic and muscle: what no one tells you
When you lose weight on these medications you don’t only lose fat. In studies, a significant part of the weight lost is lean mass, which includes muscle. And in the STEP 1 trial, people who stopped the medication regained about two-thirds of the weight they had lost within a year.
Muscle burns the most energy in your body and also gives you shape. So if you use a GLP-1:
- Eat protein at every meal.
- Do strength training.
- Use it with medical follow-up, not as an unsupervised permanent solution.
After surgery, can I keep losing weight?
It depends on the procedure. After liposuction, continuing to improve your habits helps. But with procedures like a tummy tuck or breast lift, significant weight loss afterward can change the result. Ideally, you come to surgery close to your stable weight.
Frequently asked questions
Does Ozempic cause loose skin?
Rapid weight loss can leave loose skin, especially on the face, neck, breasts and abdomen. Depending on the degree, it’s treated with technology or surgery.
What is “Ozempic face”?
It’s the more tired or aged look that appears when the face loses fat volume quickly.
Do I have to tell my surgeon I use a GLP-1?
Yes, always. It’s key information for your safety under anesthesia.
If you’re using or considering a GLP-1 and want surgery, we’ll plan it together in your consultation, which is always free. Book here. You can also read our 90-day surgery prep guide.
About Dr. JC Alvarez. Dr. Julio Clavijo-Alvarez is a plastic surgeon certified by the American Board of Plastic Surgery and a Fellow of the American College of Surgeons. He trained at the University of Pittsburgh, where he researched adipose-derived stem cells, with studies published in Plastic and Reconstructive Surgery, and he is the lead author of a national survey of 596 plastic surgeons on preventing blood clots in body contouring surgery. He is the author of Behind the Mirror.
Sources: ASA multi-society GLP-1 guidance (2024) · Wilding et al., STEP 1 trial extension (2022)
This article is for educational purposes and does not replace a medical consultation. Every case is evaluated individually and results vary.
