Jen, 41, documented her journey on TikTok, sharing a milestone many only dream of: losing 180 pounds. But the significant weight loss, achieved with the help of a GLP-1 medication, left her with a new challenge – excess skin. Rather than hide, Jen chose to address it, not just for aesthetic reasons, but to feel fully aligned with the health and well-being she’d worked so hard to achieve. Her experience, and her decision to undergo an “awake” arm lift, is sparking a conversation about body transformation, the evolving landscape of plastic surgery, and the need to destigmatize procedures following substantial weight loss.
GLP-1s, or glucagon-like peptide-1 receptor agonists, have gained prominence in recent years, initially as treatments for type 2 diabetes and increasingly for obesity. Medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) work by mimicking a natural hormone that regulates appetite and blood sugar, leading to significant weight reduction. However, rapid weight loss often results in loose skin, which can cause discomfort, limit mobility, and impact self-esteem. Addressing this excess skin is becoming increasingly common, and procedures like brachioplasty – an arm lift – are often considered.
Jen’s decision to share her brachioplasty journey publicly, including the surgery and recovery process, resonated with many online. But what set her experience apart was the method of anesthesia: she remained awake throughout the four-to-five-hour procedure. “The excess skin is uncomfortable, too,” Jen explained in an interview with People. “It’s hard to describe it. It almost doesn’t feel like it’s a part of your body. You’re hiding it behind clothes. I met my goal weight, I’m at where I’m happiest and feel the best in my body, but it’s almost like my outward appearance doesn’t match it.”
The Rise of “Awake” Plastic Surgery
Traditional plastic surgery typically involves general anesthesia, which carries inherent risks, including adverse reactions to medication and potential complications during recovery. “Awake” plastic surgery, however, utilizes local anesthesia, often combined with sedation and pain management techniques like nitrous oxide (laughing gas), to minimize these risks. The technique allows patients to remain conscious, communicative, and avoid the deeper sedation of general anesthesia.
Jen described the experience as surprisingly positive. “Your body is numbed, so you really don’t feel anything,” she told People. “If you have any type of pain, there is laughing gas that you can take during it. But I only have positive memories from the surgery.”
Jen on TikTok.
Credit: @richladyproblems/TikTok
Dr. Zachary Willis of Willis Cosmetic Surgery & MedSpa in Ellisville, Missouri, has become a leading proponent of awake procedures, particularly for patients who have undergone significant weight loss. He performed 87 awake arm lifts in 2025, and also offers awake tummy tucks, breast lifts, and medial thigh lifts. Dr. Willis explained the process involves injecting a “tumescent” solution – a mixture of saline, lidocaine, and other medications – to numb the surgical area. “It is just all under local numbing,” he said. “So you take what’s called tumescent, [which is] basically just a bag of saline like you would get at the ER if you’re dehydrated or something. You just put a small amount of lidocaine in the bag and then you mix it up with a couple other things and then you inject it into the area. So then it kind of blocks that area.” He also utilizes relaxation medication to help patients remain comfortable throughout the procedure.
Addressing a Growing Need
Dr. Willis notes that while the technology for awake procedures has been available for some time, many surgeons lack the specialized training. “I’m in private practice, but a lot of these hospitals are stuck in what they’re allowed to do,” he explained, adding that he frequently sees patients who have been turned away by other surgeons due to a lack of capabilities for awake procedures. This highlights a potential gap in access to care as the demand for post-weight loss body contouring increases.
Jen on TikTok.
Credit: @richladyproblems/TikTok
The increasing accessibility of GLP-1 medications is expected to further drive demand for these procedures. As more individuals experience significant weight loss, the need for body contouring options will likely grow. Jen hopes her openness will help dismantle the stigma surrounding both weight loss medications and the subsequent procedures to address excess skin. “I get so many comments of people being like, ‘You’re vain, you’re self-absorbed, you’re a horrible person. You should just live with the excess skin,’” she shared. She believes increased awareness of the benefits of GLP-1s will foster greater understanding and acceptance.
Understanding GLP-1 Medications and Weight Loss
GLP-1 receptor agonists have demonstrated significant efficacy in promoting weight loss, as evidenced by clinical trials. A study published in the New England Journal of Medicine showed that tirzepatide resulted in up to 22.5% weight reduction in participants with obesity. While these medications offer a powerful tool for weight management, they are not without potential side effects, including nausea, diarrhea, and constipation. It’s crucial for individuals considering GLP-1s to discuss the risks and benefits with their healthcare provider.
Jen is scheduled to return to Dr. Willis in March for an awake breast lift, continuing to document her journey and advocate for open conversations about body image and post-weight loss care. Her story underscores a growing trend in plastic surgery – a shift towards more patient-centered approaches, minimizing risks, and empowering individuals to feel confident and comfortable in their bodies.
Disclaimer: This article provides general information and should not be considered medical advice. Always consult with a qualified healthcare professional for personalized guidance on weight loss medications, surgical procedures, and any health concerns.
The evolving landscape of weight loss treatments and body contouring procedures will continue to unfold. Further research and advancements in surgical techniques are expected to refine these options and improve patient outcomes. For those considering these procedures, consulting with a board-certified plastic surgeon and a qualified healthcare provider is essential to determine the most appropriate course of action.
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