Ozempic butt. Mounjuro mound-loss. Whatever you want to call it, saggy bottoms are on the rise. These so-called “Ozempic butts” are a possible byproduct of the rapid weight loss in GLP-1 patients—and plastic surgeons are taking notice.
“Ozempic butt” refers to the sagging, deflated butt skin that some GLP-1 patients find themselves experiencing. In the succinct words of one 52-year-old patient: “My behind went flat.”
Now, plastic surgeons report seeing patients who seek to mitigate the visible ramifications of GLP-1s. But is it reversible? Is it worth trying nonsurgical courses of action first, or is a surgical solution an absolute must for those concerned? This is what plastic surgeons—and the patients who sought their help—told us.
When the scale moves but the skin stays
When a person loses a significant amount of weight in a short time period—whether from a GLP-1 or any other reason—their body can experience excess, sagging skin, including on their butts. Not only does significant weight loss itself contribute to a deflated bottom when the subcutaneous fat under the skin gets smaller, but Amir Ghaznavi, a board-certified plastic surgeon in Herndon, Virginia, tells the Daily Beast that GLP-1s have been shown to decrease the amount of Type I collagen in the skin, which causes a sagging effect.
Type I collagen is especially important to giving skin a plump, “lifted” appearance because it acts almost like the structural support beams of a building, says Dr. Ghaznavi. (Type II collagen, on the other hand, is more associated with joints and cartilage.) “As those beams start to disappear with the combination of this rapid loss of subcutaneous fat,” he says, “there’s a significant amount of skin laxity.”
While the side effect’s social media moniker includes Novo Nordisk’s breakthrough medication, it isn’t specific to any one brand. (Wegovy warriors, rest assured: your experience matters, too.) No matter the maker, GLP-1s have completely changed the world of weight loss and body transformations, with an estimated one in eight adults across the U.S. having used them. And the longer these patients stay on their treatment plans, the more conversations there are about the unforeseen negative side effects of this popular class of drugs.
Maura, a 52-year-old, says she had surgery to feel good about herself. She had initially been prescribed a GLP-1 for a thyroid condition. Within a month after she started taking the medication, she saw noticeable sagging. “I was faithfully exercising and doing the things that I was supposed to, but then I was left with the body of ‘I’m skinny, but I’m flabby.’” To combat this, she sought help from Heather Levites, a board-certified plastic surgeon in Raleigh, North Carolina. She wanted a major change, but felt wary of results that might look unnatural or obvious. “I didn’t want to look like some people who walk out and they’re looking like an ant,” she recalls, referring to the insect’s dramatically segmented shape.
“Patients don’t want giant buttocks,” Dr. Levites tells The Beast. “They just want the volume back that they had before they lost weight.”
Maura ultimately underwent body-sculpting surgeries that included a butt lift and fat transfer—a decision she calls “the best thing” she ever did. “I had given everything to everybody, and I kind of put myself on the back burner. And finally, it was my time.”
How to tie up loose ends with treatments and surgery
Surgical options for treatment involve lifting the skin through excising it and filling it with fat from somewhere else. For milder cases, or when surgery may not be an option, Dr. Ghaznavi suggests trying radiofrequency and microneedling (specifically with heat and energy devices like Renuvion J Plasma), or dermal fillers like Sculptra. However, he notes that noninvasive options for moderate to severe cases typically aren’t as effective.
The most effective treatment—and what Dr. Ghaznavi calls “the board-certified answer for examinations” he teaches his residents would be a butt lift with fat transfer. This differs from a Brazilian butt lift, commonly known as a BBL, which is just fat transfer. Dr. Levites agrees that the “ideal” solution is to have a skin excision surgery combined with liposuction and BBL fat grafting to fill and plump up the volume. Dr. Levites adds that this type of butt lift is “not your traditional BBL,” but rather, a procedure intended to restore and correct volume loss, as opposed to giving the patient’s body a new physical shape.
After dramatic weight loss thanks to GLP-1s, Jessica*, a 50-year-old patient of Dr. Ghaznavi’s, underwent two butt lifts. (Only the second procedure, a revision, was performed by Dr. Ghaznavi.) According to Jessica, the work is subtle enough that people generally can’t tell she’s had surgery. So subtle, in fact, that a man she was dating before and after her butt lift wasn’t able to tell she had any work done. For Jessica, the post-Ozempic (or, in her case, post-Mounjaro) butt lift was about restoring her body to a natural baseline rather than giving her a Kardashian-era BBL.
Still, despite the relatively subtle change in appearance (particularly when wearing clothing), the results can have a profound impact on patients’ self-esteem. In fact, Maura’s post-procedure body gave her the confidence to start modeling. “It kind of gave me a second start in my life.”
*Names have been changed.
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