by Dr. Anna Steve
Ozempic Breast
“I’m too young for my boobs to look like this.”
Over the last year we’ve seen rapid increases in the number of patients taking injectable weight loss medications like Ozempic (semaglutide), Wegovy (semaglutide) and (Mounjaro) tirzepatide. Some of these medications are approved for use in weight loss and others are used off- label for weight loss. These medications have been the source of extensive weight loss success stories for many women. This rapid weight loss is in turn causing dramatic changes to the breasts.
Many women seek plastic surgery for solutions to the frustrating changes they see in their breasts following dramatic weight loss. Cosmetic surgery can help address loose skin, loss of volume and droopy nipple position (ptosis). These are all common changes seen in the breast following significant weight loss.
‘Ozempic breast’ can occur in women taking injectable weight loss medications of all types, not just Ozempic. No one medication causes higher rates of changes to the breast than another. Anyone with dramatic weight loss over a short period of time is at risk.
How to tell if you have Ozempic Breast
Features of Ozempic breast include loss of fullness to the upper portion of the breast (commonly referred to as the ‘upper pole’), loose skin, and droopy nipple position (ptosis). Many women feel deflated, flat and saggy after their weight loss successes. These changes are very similar to those seen in post-partum women, making women without children feel like ‘they are too young to have boobs that bad”.
How to treat Ozempic Breast?
These successful weight loss stories are causing an uptick in the number of women seeking breast enhancements. The approach to breast enhancement is very individualized and is influenced by the amount of weight loss. Typically, more dramatic weight loss requires more complex solutions. Less dramatic weight loss may require more straightforward solutions.
Breast implants to restore volume
Some women with less dramatic, but still rapid weight loss (10-15 lbs) may only notice loss of volume to the upper portion of the breast. These women often seek breast implants as a solution to their volume loss. Women who have lost volume without extra skin or droopy nipple position are often candidates for breast augmentation without a breast lift.
Women who have recently shed weight are often hesitant to add the volume of an implant because they fear going back to feeling too large. Thankfully there are many small volume implants available that offer a modest boost in volume without making women feel larger.
We are focusing more and more on lower profile implants (less round shaped) for more elegant, natural- looking results. Attention to patient’s frame can also avoid choosing an implant that creates excessive side-boob and making women look larger.
Breast lift to remove extra skin and improve nipple position
Women who have developed loose skin and droopy nipple position may also require a breast lift in addition to breast augmentation. Breast implants and breast lifts can be performed at the same time (augmentation mastopexy). The combination of a lift with implants is one of the most common breast enhancements following weight loss.
Breast reduction with small volume implant to avoid looking too large
Some women also desire further reduction in size after weight loss, but also have the competing goals of wanting to add volume back to the upper portion of the breast. For women with these goals a breast reduction can be combined with the power of a small volume implant. This facilitates volume restoration and return of structure to the breast (think- the ability to go braless and maintain shape) without adding cup sizes. Women seeking breast reduction without an implant may feel underwhelmed with the restoration of shape and volume, particularly to the area above the nipple.
Two additional tools have further customized the options for women seeking breast enhancement after dramatic weight loss: the internal bra (for additional support), and fat transfer (for more natural- looking results.
Internal bra for support from the inside out
Many patients experience skin and tissue laxity after weight loss, putting them at higher risk of the implants dropping too low. For this reason, a tool called the internal bra might be used to provide additional support for breast enhancement.
There are many different types of internal bra, but a popular brand is a product is a tool called GalaFLEX. This type of internal bra is made of the same material as dissolving stitches and replaced by your body’s own tissue by collagen over time. As the internal bra is dissolved, your body forms a strong layer of support to replace it. This collagen support layer helps hold the implant in position over time.
Fat transfer for custom cleavage
Fat transfer (also known as fat grafting) is often combined with implants for more natural- looking results. Fat transfer is removed from remaining stubborn areas of the body using liposuction techniques and transferred overtop of the implant to soften aesthetic lines. It’s an extremely powerful tool for women who want to avoid visible implant borders after breast augmentation.
The fat grafting is usually added to the areas where implant borders would be most visible to camouflage the implants and customize cleavage. An added bonus is that fat transfer can be added to the breast without any additional scars.
Some women wonder if fat transfer alone is a good solution for ‘ozempic breast’. While an ‘all natural’ breast enhancement sounds good in theory and this thought process makes sense (because it was in fact weight loss that caused the dramatic changes to the breast), unfortunately, fat transfer lacks structure, and alone it doesn’t fix ‘Ozempic Breast’.
Fat transfer is frequently combined with the volume of an implant for the most natural, elegant- looking breast enhancements. Fat transfer can also be combined with a breast lift for women who don’t require the structure of an implant to achieve their aesthetic goals.
When to address Ozempic Breast?
The best time to treat Ozempic Breast is once you’ve reached your goal weight. Plastic surgery outcomes are always optimal when your weight is stable. If you plan for further weight loss after surgery, you could jeopardize the longevity of your results. Further weight loss can result in return of volume loss, loose skin and recurrent drop of nipple position after cosmetic surgery.
This patient chose to have breast enhancement following over 100 lbs of weight loss with injectable weight loss medications. She combined the power of a small volume implant with a small volume breast reduction and lift for this subtle, natural- looking result.
Individualized planning for optimal outcomes
While injectable weight loss medications are causing a range of dramatic changes to the breast, there are many solutions. The approach to “Ozempic Breast’ should be individualized to meet each patient’s desired aesthetic outcomes. In simple cases, reconstruction after weight loss may involve only an implant, while in others an implant may be combined with a breast lift, breast reduction, internal bra, and or fat grafting.