By: Adriana Sinclair
Search for what GLP-1 drugs are doing to the plastic surgery market and the answer that comes back is one word: restoration. The American Society of Plastic Surgeons put it in the headline of its 2025 Procedural Statistics Report, released September 1, and its president said patients are “increasingly seeking authentic restoration rather than transformation.”
The numbers under the slogan are real. Cosmetic surgical volume rose 7 percent in 2025, according to the report. Facial fat grafting grew 39 percent, the largest gain of any procedure tracked, and facelifts rose 13 percent. Patients 66 and older recorded a 24 percent rise in procedure volume, the largest of any age group, while volume among 18 to 25 year olds fell 9 percent. And 82 percent of ASPS member surgeons reported receiving consultation requests related to GLP-1 use last year.
ASPS is careful with that last number. The release says the statistics “do not establish a causal relationship or growth in any specific procedure category.” It is counting conversations, not operations.
What the report cannot count is what happens when the drug gets cheaper. On February 24, Novo Nordisk said it would cut the US list price of Wegovy and Ozempic by up to 50 percent, to $675 per month, effective January 1, 2027, from around $1,350 for Wegovy, according to CNBC. Cheaper weight loss, when it works, produces loose skin, and the only durable fix for loose skin is an operating room.
What One Practice Actually Sees
Frank Agullo, a clinical associate professor of plastic surgery at Texas Tech University Health Sciences Center who trained at the Mayo Clinic and runs a private practice in El Paso, has an obvious commercial interest in the restoration story, and practice-level numbers the national report does not publish.
“About 30 percent of my patients involve a patient who has lost weight on GLP-1s,” Agullo said. “Before the GLP-1 era, my post-bariatric weight loss surgery practice was about 10 percent.”
The composition surprised him more than the volume. “The most common procedure after GLP-1 weight loss right now is a deep plane facelift, a deep neck lift, and/or an endoscopic deep plane facelift, also known as the ponytail lift,” he said. “This is surprising, because in the post-bariatric patients the most common procedure was a lower body lift, which addressed the abdomen, the buttock and the thighs.”
That fits the ASPS facial figures, though one surgeon’s case mix is an anecdote with a stake attached.
Where his account cuts against the national story is the Brazilian butt lift, the emblem of the transformation era the society says is ending. “My BBL volume has not dropped in my practice,” he said. “We’ve seen a transition to less volume and more natural silhouettes, but it’s still in very high demand.”
The Premium on the Post-Weight-Loss Version
The same operation costs more on a patient who has lost a great deal of weight, and the reason is the clock rather than the technique. A tummy tuck, breast lift or buttock lift on a massive weight loss patient “may take a little bit longer, maybe an hour, because there is a lot more skin and tissue to be removed versus a patient that has not lost weight,” he said. OR and anesthesia time is billed by the hour, so it shows up on the invoice. “The difference is usually going to be in the two to three thousand dollar range.”
Agullo’s practice publishes all-inclusive starting prices, covering the surgeon’s fee, anesthesia, the facility, tests, garments and recovery products. Those are floors, not quotes, but a published floor gives the $2,000 to $3,000 premium something to be measured against, which a fee-only national average does not.
The other lever is bundling, because surgical costs are front-loaded. “That first hour is the one that pays for all the supplies, the medications, the preoperative time,” Agullo said, so combining two procedures in one session pays that fixed cost once. He caps combined sessions “usually under six to eight hours,” and the saving comes bundled with a longer anesthetic.
He also flags a cost that lands later. “The most important thing is for the patient to be stable at their weight,” he said. “If they continue to lose, or go up and down, they may need more procedures in the future.” A cheaper drug that keeps working after the first operation is, depending on which side of the invoice you sit on, either repeat business or a second bill.
What 2027 Looks Like From the Operating Room
Asked what the price cut will do to demand, Agullo did not hedge. “As the cost of GLP-1s has decreased, I’ve seen more patients on GLP-1s, more patients successfully losing weight and getting toward their ideal weight, and an increase in patients seeking correction of the loose skin and loss of volume,” he said. “I foresee a continued increase in demand for these surgeries.”
On the society’s larger claim, that the market has moved from transformation to restoration, he agreed only in part. His counterexample was rhinoplasty, one of the most common operations he performs. “They’re not trying to get back to something they were before; they want to optimize their facial aesthetics,” he said, and he hears the same from younger patients. “So I think young patients are still looking for transformation.”
The ASPS age data, under-25s shrinking and over-65s growing, points the same way: less a change in what patients want than in who is buying. “I still feel that the overall majority of patients would like to obtain a better version of themselves,” Agullo said, “even a better version of themselves before they had their changes through weight loss, aging or pregnancy.” It is also the belief a surgeon would be expected to hold. Whether it survives a $675 monthly drug price is the question 2027 will answer.
Frank Agullo, MD, FACS, is the founder of Southwest Plastic Surgery in El Paso, Texas.
Contact Information
Dr. Frank Agullo, MD, FACS.
Double Board-Certified Plastic Surgeon.
Southwest Plastic Surgery · El Paso, Texas.
Phone: (915) 590-7900 · Text: 1-866-814-0038
Web: www.agulloplasticsurgery.com
Disclaimer: This article is provided for general informational and educational purposes only and is intended for informational purposes. The information presented should not be considered professional medical, financial, legal, or other professional advice, nor should it be used as a substitute for consultation with an appropriately qualified professional. Information, statistics, opinions, pricing, and other details referenced in the article may change over time and may vary depending on individual circumstances, location, provider, or other relevant factors. Readers should independently verify information before making decisions based on the content. No particular outcome, result, or benefit is guaranteed.
