Weight Loss Drugs Causing ‘Ozempic Butt’ & Excess Skin: When Plastic Surgery is Required

Tue 22nd Apr 2025

The demand for injectable weight loss drugs across Australia and the globe continues to grow. And while there’s no official data on the surging number of Aussies benefiting from these medications in the last year, they’ve been hailed by many as ‘the biggest drug boom in decades’.

The important thing is that these drugs should only be obtained via a prescription from your general practitioner or specialist endocrinologist. Furthermore, your overall health and response to these medications needs to be carefully monitored throughout your treatment plan. These drugs should never be accessed outside of these proper medical pathways.

It seems like everyone’s talking about Ozempic, the most commonly named weight loss drug, and its startling effectiveness in promoting weight loss. But Ozempic is not the only one that sits in this popular camp. There are other similar medications, such as Mounjaro, Wegovy and Saxenda. Here’s how they differ:

Ozempic (semaglutide) and Saxenda (liraglutide) are GLP-1 (glucagon-like peptides) receptor agonists. These drugs suppress appetite by producing a naturally occurring hormone called GLP-1, which regulates blood sugar levels.

Wegovy (semaglutide) is more of the same but in a higher dosage.

Mounjaro (tirzepatide) is a dual GIP and GLP-1 receptor agonist. This dual action helps with insulin sensitivity, weight loss, satiety (fullness) and blood sugar control. Clinical trials have shown greater weight loss with tirzepatide compared to drugs like semaglutide.

While there’s been quite a fuss about people experiencing rapid and often substantial weight loss from these viral drugs, other side effects are starting to gain attention. New catchphrases are circulating on the Internet: first, there was ‘Ozempic face’ and now, ‘Ozempic butt’. For some, it’s nothing more than a giggle, while for others, it’s a deep concern. So what’s going on?

What Is ‘Ozempic Butt’?

‘Ozempic butt’ is a non-medical name that refers to the wrinkled, loose and sagging skin that some individuals are noticing on their newly slimmed-down backsides since taking semaglutide or similar drugs. It’s not a direct side-effect of the medication, however. You can see this effect after any rapid weight loss.

When we lose significant amounts of weight, the areas of the body that typically store an abundance of fat, such as the face, tummy, bottom, arms and thighs, change shape. Instead of being tight and firm, they often end up with loose sagging skin.

To compound this problem, those that experience rapid weight loss due to significant calorie deficiency, typically also lose a great deal of muscle. This compounds the often gaunt and sometimes unhealthy appearing look that has been associated with people that have experienced rapid weight loss, regardless of whether that has been surgically or medically assisted.

If the person had developed significant stretch marks during the process of becoming fuller figured, then this will also make any subsequent weight loss, whether that is quick or slow, a problem. Skin with stretch marks is effectively damaged and scarred skin, and has very limited ability to tighten with any weight loss.

Skin that has been expanded for a long time, and especially that with stretch marks,  has basically lost its ability to contract or ‘shrinkwrap’ around the smaller lighter body and sags instead. The more weight you lose, the more obvious this sagging becomes.

Age is also a factor in skin elasticity. The younger we are, the more viscoelastic the skin is, enabling it to recoil after being stretched. As we age, the skin loses elasticity and is more likely to sag.

However, there is a significant genetic component to how a skin behaves as someone loses weight. You could line up 10 people of similar age and height, that have all lost 50kg, and they will all look very different.

So a person that has gone through all the hard work and effort to change their life, lose weight, become fitter and healthier, should feel on top of the world. Unfortunately, this incredible achievement is often accompanied by a degree of depression due to the excess sagging skin which is not only a physical and function impediment to their life, but a constant reminder of their former self.

Of course, if it’s only been a small amount of weigh loss, you may be able to remedy the problem by weight training and exercise, increasing the muscle volume to compensate for the fat loss in particular body areas. But when your weight loss is significant, no amount of exercise—or creams or laser treatments will fix this problem. The only solution to problematic excess skin is surgery.

Surgical Body Contouring Options for Excess Skin

Body Contouring surgery is the name given to a set of surgical reconstructive procedures that address the often significant aesthetic and functional concerns of loose, excess skin. Using a dressmaking analogy, the surgeon must tailor your skin to fit your now smaller body.

Numerous Body Contouring surgical procedures are available, depending on an individual’s requirements. Dr Dona has developed a system grouping the key surgical procedures frequently required after dramatic weight loss. He calls them ‘The 7 ‘B’s of Body Contouring Surgery. They are:

• Brachioplasty (Arm Reduction): Removes excess skin from the upper arm.
• Breasts – Lifts, Reductions and Augmentations: The breast can be reshaped in various ways depending on the patient’s concerns.
• Bra Lipectomy (Upper Body Lift): Removes excess skin rolls and associated fat in the upper and middle part of the back and around the bra strap area.
• Belly – Abdominoplasty (Tummy Tuck): The abdominal wall can be reconstructed depending on the patient’s needs, addressing issues such as excess skin folds, muscle separation and damage, drooping (in the mons region) and possible abdominal wall hernias.
• Belt Lipectomy (Lower Body Lift, 360 Tummy Tuck): Removes rolls of excess skin and associated fat in the lower back, flanks, upper outer thighs and abdominal region. It also lifts the buttocks and pubic areas.
• Buttock Surgery: Removes excess skin from the lower back, lifting and tightening the buttocks.
• Below the Waistline Surgery – Genital And Thigh Surgery

Good Candidates for Body Contouring Surgery

Good candidates for Body Contouring Surgery are in good health, have realistic expectations about the intended procedure/s, and understand the associated risks. Body Contouring procedures are not weight loss procedures; they are reconstructive procedures that address excess skin tissue. Therefore, you should be able to maintain your ideal body weight before committing to the procedure.

You should also be a non-smoker as smoking or ingesting nicotine-based products constricts blood vessels, reducing oxygen levels at the surgical sites. This hinders the healing process and increases your risk of complications. Smokers also have an increased risk of anaesthesia complications, so you must quit weeks before your surgery.

Bilateral Buttock Lipo-augmentation

If your weight loss medication has allowed you to return to a healthy body weight, but you’ve lost shape and volume in your buttocks, you may wish to discuss Bilateral Buttock Lipo-augmentation Surgery with Dr Dona. This surgery involves two procedures — liposuction and fat transfer. Fat is suctioned from another part of the body and transferred into the buttocks. This transfer adds volume and enhances the shape and roundness of the buttocks. It also lifts the buttocks by adding more volume to the upper and outer aspects.

Suitable candidates must have an adequate amount of fat in other areas of their body. If a candidate is too thin, they are not suitable for these procedures. Potential candidates will also have realistic expectations about their surgery, post-operative course and likely results.

Combining Surgical Procedures

If you’ve lost significant weight, you might need more than one surgery. In that case, two or more procedures can be combined in one surgery. This will save you time and considerable expense — by multiple procedures sharing the cost of the anaesthetist and hospital fees. If you’d like more procedures done, we suggest you prioritise your concerns, discuss them with Dr Dona, and then schedule future surgeries in order of importance, allowing at least three months between each surgical procedure.

Importantly, if you are taking injectable weight loss medications, it’s vital you tell Dr Dona and your anaesthetist, as they will need to consider this and provide you with appropriate instructions.

Patients taking GLP-1 receptor agonists and dual GLP-1/GIP receptor co-agonists have been associated with an increase in anaesthetic complications due to the affects these drugs have on gastric emptying. The guidelines for patients undergoing surgery have recently changed to address these issues. Patients can now continue taking these medications up until the day of any surgery (or procedure requiring sedation). However, they must only consume a clear fluid diet for the 24hours prior to the planned procedure.

Choose Your Plastic Surgeon Carefully

If you’re keen to explore Body Contouring Surgery, we encourage you to choose your Plastic Surgeon carefully. You only have one body, and it’s vital you choose an experienced, qualified plastic surgeon familiar with these weight loss issues to give you the best chance of achieving optimal results. Look for a surgeon with a proven track record in managing the many varied and often complex weight loss patients — and ensure you see numerous examples of their work.

Plastic Surgeon Dr Eddy Dona has spent nearly 20 years perfecting his surgical craft. Further, much of his private practice is dedicated to looking after patients who have experienced massive weight loss. A meticulous practitioner, Dr Dona consistently refines his surgical skills, maintaining a steadfast commitment to excellence in plastic surgery.