Ozempic Plastic Surgery

New York Ozempic Plastic Surgery

Obesity is a major public health issue, with more than 2 in 5 adults in the United States classified as obese. While lifestyle modification is the gold standard for weight loss, those seeking effective medical treatment for obesity were previously limited to various forms of bariatric surgery.

For 300,000 years of human existence obesity was rare; now it’s probably the biggest health concern in America. Why? Data says this began when society changed from eating fresh whole foods prepared and consumed daily to eating processed foods that are manufactured. Processed foods undermine the human brain to not feel full even though you are eating calorie rich food.

Just after the pandemic, many people gained a lot of weight. Everyone was talking about how as soon as it was over they were planning on dieting and exercising again to get their bodies back and rejoin social society.

Well, something happened. You may have gone to a party after the pandemic and noticed that those people who were all saying they had gained a lot of weight were actually looking thinner than they ever had. This was perplexing for me that was for sure. All my ideas of weight gain and the slow weight loss through diet and exercise were changing. Something must have happened.

Well, something did happen and it happened about 4 years ago. It’s called Ozempic. So, I started my research and found that the data was saying that if you take:

• Ozempic, you lose 15% of your body weight
• Mounjaro, you lose 21% of your body weight
• And apparantly there is a new one coming that causes 24% of body weight loss.

Ok, so this was important. We know obesity is serious. It causes heart problems amongst other things and heart disease primarily causes premature death. Since World War 1, every decade there has been a new “miracle” weight loss medication but every time there was an un intended side effect that left a wake of hurt people.

Big Picture: if your BMI is over 27, these drugs reduce heart attacks by 20%. *Calculate your BMI using this helpful tool.

If you can lose weight and keep it off with diet and exercise its clearly better; look at Japan – they have changed their society and culture so they don’t need drugs like this but we are not there yet.

So, What About More “Traditional” Methods of Weight Loss?

Bariatric Surgery

Up until now, bariatric surgery was a comparable. On average you are 56% less likely to die of a heart attack, 60% less likely to die of cancer, and 92% less likely to die of diabetes related medical issues if you had bariatric surgery for weight loss. So, we do know that reversing obesity has huge benefits. Bariatric surgery is rough and has 1 in 1000 death rate which is a high number so the reason not everyone is running to save their life with bariatric surgery is that it’s very risky.

Dieting

Let’s look at the data and science of dieting. Most people on diets do not lose weight. 1000s of studies show diets work over the short term, most of the studies stop looking at people at 6 months after they start the diet. So, what happened when they looked at diets for two years. Only 24 studies are available on this long-term data. On average at 2 years people are only down 2 pounds after following a diet. The evidence is clear that you would be a huge statistical outlier to lose a lot of weight through diet and keep it off. Its debated and controversial why this happens. In the 1970s it was thought that genetically you had a set point for weight almost like your body temperature so you can go a little up or a little below it but your body will move toward its biological set point. If this was true how did the obesity crisis occur, well current hypothesis is that society and culture with processed foods actually moves your biological set point by altering your cravings, hormones, and metabolism. In darwinian terms or evolutionary concept our brain was designed to protect us against famine. In the modern world our brains are driving to consume as much calories as available to prepare us for a famine that will never come. Again, these concepts are debatable but I summarized the data for interest purpose of the reader.

“Ok Doc, But I Remember Fen-Phen In The 1990s”

By 1995 , 18 million people were on “Fen-Phen”. It was an appetite suppressant combined with a stimulant. It was found that it caused heart and lung problems and it led to a 12-billion-dollar lawsuit against the pharmaceutical companies. So, it’s normal to be skeptical.

A Brief History of Ozempic and How it Was Made

For more than a 100 years, people in the scientific community were discussing that something in the intestine that would increase insulin and decrease blood sugar while reducing your appetite. In 1984 two groups identified the substance and it called glp-1. These groups came out of Denmark and Germany. Novo Nordisc, the company that had primarily been in the insulin business and also based out of Denmark, started immediately trying to make a drug out of it. Because it was a natural substance, they could start putting it in humans to see what happened. What they noticed immediately was how short acting the substance was. They literally tried everything from pills to pumps to get it into humans. Glp-1 means glucagon like peptide for those who were wondering. In the 1980s when this started it was a slow offline world so scientific research happened in silos which means it would take a long time for groups all over the world working on the same thing to collaborate. So, what they did was they took glp-1 peptides and attach it to fatty acids. Why fatty acids? The body is not that great at breaking down fatty acids, which means the glp-1 injected into you lasts longer. What is interesting and a common misunderstanding is that Novo Nordisc realized later that glp-1 also causes weight loss, they actually knew from the beginning and it literally took 20 years to get approval which may explain why the cost is so high for these medications.

How do Ozempic and glp-1 medications work?

Basically, after you eat, your pancreas makes glp-1 and this tells your brain you are full and to stop eating. These medications are an artificial glp-1 that sticks around for a week, not just a few minutes, like your bodies internal glp-1 so you feel full for a week.

So What Does This Mean?

Every single day we are seeing people who have lost a considerable amount of weight from Ozempic and Mounjaro and have a lot of extra skin that they want to be removed – because the weight is not really gone unless the skin is gone. At Neinstein Plastic Surgery we have developed an approach that maximizes results for our patients so they can more fully enjoy their weight loss.

Ozempic & Plastic Surgery: Our Suggested Approach

Stage 1

Circumferential tummy tuck with buttock reshaping combined with breast styling (combining lifts, implants, reductions, fat grafting, internal bras).

70% of patients are so happy after our Stage 1 Ozempic plastic surgery that they don’t even go on to Stage 2 and Stage 3!

We love Stage 1 because all the scars are hidden in a bikini and it completely changes the way you wear clothes and interact with the world. The goal is to be happy not happier and happiest – less is more!

Stage 2

If we mutually determine more needs to be done to achieve the right aesthetic we move on to our Stage 2 Ozempic plastic surgery which introduces Arm lift and thigh lift.

Stage 3

Bra line back lift is our Stage 3 Ozempic plastic surgery.

Things to Keep in Mind

• The weight-loss medication must be stopped 3 weeks before surgery for safety.
• For three weeks before and three weeks after surgery we ask our patients to have 75g a day of protein (3 scoops) to help healing.

What Does This Mean For Plastic Surgery?

In simple terms, people are losing a lot of weight and are left with a lot of loose skin. We are doing weight loss medication related procedures weekly, and basically daily, at Neinstein Plastic Surgery. Below is an explanation of the common procedures we are doing. It’s important to remember these procedures have been developed to match the changing landscape of the patients presenting. We built on longtime experience of body contouring, allowing us to bring mastery to these procedures. Remember, we don’t do anything else; our mind is not occupied with facial or non-surgical plastic surgery, so we learned and evolved quickly and are always on the cutting edge because is what people deserve.

Circumferential Tummy Tucks

We used to do tummy tucks that went just past the classic hip to hip scar but now that people are coming to the office with loose skin on their sides and their backs, we are doing these procedures that actually address all of the concerns. I can’t remember happier patients who could care less that they have a scar that goes around their body. Can you imagine going from a big person who was uncomfortable in their body to a thin person wearing anything they want and excited to see themselves in the mirror? Big takeaways – its not just obese people using these medications. A lot of our moms and patients over 50 are using them to help get the last 15-20 pounds off. These people who have lost a lot of weight are coming to see us from all over the world because we “get it”. It’s not just a tummy tuck – we have completely changed our approach to tummy tucks to help everyone who has lost a lot of weight to not just get their skin off, but do it with elegance and sophistication so the final result is still long lean and elegant. Here is a mom who lost 70lbs after her last pregnancy. She had a lot of up and down weight changes with IVF so her Miami dermatologist said just go to New York and get it done the right way at Neinstein Plastic Surgery.

Tummy Tucks on Patients Without Children

We are seeing 25-year-old students, 37-year-old lawyers, 44-year-old heart surgeons who have been stuck their whole adult lives with excess weight that just wouldn’t move. Mounjaro and zep bound specifically have brought them over the hump and have allowed them to finally lose the weight. Regardless of how you end up with loose skin on your tummy the rolls will not go away with liposuction or anything non-surgical. Our commitment to the scar and the scar placement from performing 1000’s of procedures has brought these patients to us. I know what you are thinking, “how can someone without kids have a tummy tuck”? You need to change the way you are thinking because I can tell you these may be the happiest people. They get to actually live their life with a sexy look and feel for the first time. The scar fades – I mean we are scar obsessed so you don’t have to be. We use incision management systems, meticulous suturing with tiny sutures by the surgeon and we have a very complex after care program all designed to maximize the scar quality. Here is a very busy mid-town lawyer who has no kids, loves life, and lost 110 pounds after her tummy tuck:

Full & Extended Arm Lifts

The arms are how we interact with the world. So many clothes women tell me they want to wear involves showing their arms. For years people have been scared about the scar from arm lifts. I know I keep saying this but its true – our patients really don’t care about the arm lift scar. Most of our patients who get arm lifts are older but now with the glp-1 era of weight loss medications we are performing the arm lifts almost daily. The scar is placed on the inside of the arm in a special location that from the front the side and the back you cannot see the scar. I always joke that you would have to be doing the YMCA dance for people to find the scar. What is also nice about this area of thin skin is that the scar in time really fades away. The arm lift can also be extended down the side of the chest wall into the breast area where a breast lift incision may be. This extension helps get rid of all that skin you can grab next to the breast. Our new technique is way better than the old school dissection technique. Now we simply remove the skin in the area of the hanging “bat wing” arm skin to preserve the underlying structures like nerves, arteries, veins, and lymphatics which means to the patient healing is easier with less complications. Fact: women hate loose hanging arm skin.  Women love sleek chic arms and they get over the scar every time because they finally love their arms and love showing them off!

Breast Work

Of course breasts become droopy, saggy, and deflated. So we want to add volume and lift the breasts. Our very own breast specialist Dr. Anna Steve has put together a deep dive blog into ozempic breast surgery. Fact: we use a lot of internal bras in breast surgery after weight loss and here is why –  all of the tissues become loose so if you just put in a breast implant and did a lift the implant would fall so we use an internal bra to hold the implant so we can preserve the breast shape longterm.

Bra Line Back Lift

Think of this as a tummy tuck for your back. We mark a straight line across where you wear your bra/bikini so the scar (which nobody cares about anyways) is always hidden. This procedure basically removes all the loose back skin, it creates a smooth curve from the waist to the neck. This procedure has no drains!

Pubic Lift

This is usually combined with the tummy tuck. The mons or pubic area can stretch causing an unwanted bulge in the pubic area. It’s a combination of skin and fat. Now this procedure is actually quite delicate and takes a lot of experience. Our goal is to thin the area out and remove excess skin. Now this has to be done in harmony with the tummy tuck so there is no shelf. It takes expertise to know how much skin to remove above in the tummy tuck and below in the pubic lift so that the abdomen and pubic have an elegant appearance which is important for not just in clothing but the sexuality aspect. Interestingly, this has become very popular in men. We are seeing a lot of men who after losing a lot of weight find that when the pubic skin stretches the penis falls down. In those situations we will remove the skin from the belt line to the penis to bring it back up to its proper position.

Thigh Lift

Similar to the arm lift we are able to place the incision in the middle of the inner thigh typically going from the groin to the knee. This prevents the scar from being visible from the front, the back, and the side. Healing takes longer in the leg, it just does. It’s farther from the heart and closer to the ground which means it’s harder to get rid of the swelling. Surprisingly the upside of removing excess thigh skin far outweighs the downside of having a scar. The patients are incredibly satisfied and grateful for the positive change in their life from this operation. It’s time to take the next step; the life you wish you were living may just be on the other side of one courageous decision. We want to be your guide and instrument of change. We have amazing surgeons and a team that really wants to help. Email info@neinsteinplasticsurgery.com tell us you are ready to make a change in your life. Our team will call you and set you up with the surgeon best suited for you.