Medications like GLP-1 aren’t just speeding up weight loss. They’re also changing doctors’ views on what happens next. As patients shed pounds more quickly and substantially than before, surgeons are encountering new challenges related to skin that has lost elasticity, ways to reshape the body, and ensuring their well-being over time.
To get a better sense of how this shift is playing out in actual medical practice, we spoke with Dr. Morad Askari, founder of Revive Surgical Institute. In 2025, Dr. Askari was voted America’s Best Plastic Surgeon by Newsweek. His unique practice sits right between medical weight loss and surgical care afterward.
Below, he shares his thoughts on how GLP-1 drugs are altering patient expectations and how body contouring surgery is adapting in response.
GLP-1 weight loss has been called a “paradigm shift.” From your vantage point, what’s actually changing inside the clinic?
Dr. Askari: Certainly, it’s incredible how quickly patients are losing weight nowadays. Sometimes so fast that their bodies can’t keep up. This rapid weight loss is excellent from a medical standpoint. But biologically speaking, there’s a downside: skin doesn’t always have time to adjust.
We are seeing a new phenomenon emerging – people who feel healthier than ever but are physically uncomfortable because of excess skin.
Yes, they have achieved the hard part – shedding those pounds. But now they find this surplus epidermis is the final hurdle preventing them from fully celebrating their success.
Many people assume loose skin is purely cosmetic. Is that how patients experience it?
Dr. Askari: No, not in the slightest. That’s a major misbelief that once you lose a large amount of weight, any problems, like feeling uncomfortable or having hygiene issues because of excess skin, will go away on their own.
For some people, exercising is difficult because the skin folds get in the way or pull uncomfortably. Others find they have less choice with clothes or even how they stand.
What is interesting is that these patients were often extremely motivated and disciplined. They really wanted to be active. But excess skin became a barrier to this. In that sense, skin removal surgery helps you maintain weight loss and improve your appearance.
Do GLP-1 patients present differently than traditional post–weight loss patients?
Dr. Askari: Yes, this is really accurate. In the past, when patients lost a lot of weight (for example, because they had hadbariatric surgery), we were used to seeing them months or even years later.
Now with the GLP-1 drugs, people are having dramatic weight loss much faster, and sometimes unexpectedly. They come to us several months into their journey.
They want to know if now is the right time for the skin removal surgery, whether it is safe to have an operation while still losing weight, and if surgery is necessary at all. Education becomes paramount because patients do not want extremes; they are seeking guidance.
What areas of the body are most affected after rapid GLP-1 weight loss?
Dr. Askari: When it comes to areas of worry, I would say the tummy steals the show, particularly if there’s loose muscle and extra skin. But concerns crop up in other places, too: arms, thighs, and chest.
Female breasts undergo striking changes. Slimming down can leave them deflated or saggy despite regular arm workouts. That’s why post-GLP-1 slimming surgery may need a holistic approach so things look in proportion rather than spot-fixed.
Timing seems to be a recurring theme. How do you help patients decide when to move forward?
Dr. Askari: Timing is a crucial discussion that we need to have. I usually tell patients to wait until their weight has plateaued. If it is still falling or they are changing doses of medication, it is usually too soon.
When it comes to surgery, stable weight helps us protect the results; from the patient’s perspective, it can also lessen disappointment. We don’t want to hurry things along only to find they don’t hold – better to take our time and help ensure they do.
How do you manage expectations for patients who may think skin will “snap back” over time?
Dr. Askari: The topic of discussion is biology. Age, genetics, and duration of stretching determine how elastic skin is. If someone loses weight quickly, it does not adapt – there isn’t enough time.
It’s important to me that patients know surgery doesn’t mean something went wrong; it’s about how bodies work. Clear information like this can help them decide what to do without feeling bad afterwards if things don’t turn out perfectly.
There’s growing interest in combining medical and surgical care. How do you see that integration evolving?
Dr. Askari: This is the direction healthcare is going. It doesn’t make sense for weight loss, metabolic health, and body contouring to be separate things. The different specialties, like primary care, endocrinology, and surgery, need to talk to each other.
People who take GLP-1 agonists should be told early on that their skin might change. Even if they don’t think they’ll have an operation straight away, knowing what could happen makes them feel ready for it if it does, instead of shocked afterwards.
From a surgical standpoint, what principles guide your approach to skin removal after GLP-1 weight loss?
Dr. Askari: Control and purpose. I understand that these patients have made significant strides in their well-being. So, I think that surgery should back them up, rather than take center stage.
Our goal is to take away anything that hinders comfort or motion, add back in structure where needed, and provide outcomes that fit seamlessly with each patient’s physique. This approach guides all aspects of our work here at Revive Surgical Institute. It is also one reason why Newsweek named me America’s Best Plastic Surgeon for 2025.
Looking ahead, do you expect demand for skin removal surgery to continue rising?
Dr. Askari: Definitely, GLP-1 drugs are not just a passing fad. As they become more available, a greater number of people will benefit from substantial weight reduction but also face the problem of excess skin.
The crucial thing here is education. Patients must grasp that losing weight constitutes only one part of changing their bodies. It has to adapt too. And if necessary, surgery can safely and sensitively help bridge this gap.
Meet Abby, a passionate health product reviewer with years of experience in the field. Abby's love for health and wellness started at a young age, and she has made it her life mission to find the best products to help people achieve optimal health. She has a Bachelor's degree in Nutrition and Dietetics and has worked in various health institutions as a Nutritionist.
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