GLP-1s Could Double Aesthetic Patients in Five Years, Experts Say

The GLP-1 boom could add eight to 10 million patients to the aesthetics market within five years — doubling its size, by facial plastic surgeon Steve Dayan, MD's math. "Are we ready for another eight to 10 million patients in our space?" he asked. "I don't know if we're ready for that yet."

Dayan moderated NewBeauty's first The State of Aesthetics roundtable on Oct. 19 at SHiFT Midtown in New York. The 90-minute conversation gathered dermatologists, plastic surgeons, an endocrinologist, a menopause specialist and industry leaders from NewBeauty and partners Artemis, Merz Aesthetics, Motiva and Novo Nordisk. NewBeauty CEO Mike Glaicar said the goal was uncovering "those little gold nuggets" that help providers navigate what comes next.

Who is the GLP-1 patient now?

Dayan opened with a history lesson: "I don't think people realize they're in a revolution until after the fact."

New York endocrinologist Rekha Kumar, MD — a Novo Nordisk guest, triple board-certified in internal medicine, endocrinology and obesity medicine — said the stigma around weight medication has largely flipped. "The GLP-1 patient today is very different than who the GLP-1 patient was five years ago, 10 years ago and even 20 years ago," she said. Patients once hid older diabetes drugs' role in their weight loss; now some ask why they weren't offered a GLP-1 sooner. "It seems like this group is excited about seeing more patients, whereas the traditional mentality in medicine is people don't want more patients," she said.

Who should hold the prescription pad?

Austin, TX plastic surgeon Johnny Franco, MD, who lost 90 pounds on the medication himself, splits care into four phases: preventive, active, treatment and maintenance. "As long as you're actively losing weight, you should be actively treating your skin," he said.

New York dermatologist Doris Day, MD described the opposite extreme: a patient who arrived "literally skin and bones" after ordering medication online with no follow-up. "We're creating medically induced anorexia because it's become commoditized telemedicine, and patients are getting it everywhere," she said. Palo Alto plastic surgeon Dean Vistnes, MD said his practice SkinSpirit stopped offering GLP-1s once they became commoditized.

Kumar cautioned against tight gatekeeping. "I fear that the more we gatekeep, the more sketchy, non-clinically guided opportunities we're creating," she said. Her middle ground: aesthetic doctors don't need to become obesity specialists, but should have "some very close connection, collaboration or somebody in the office" who is.

How does menopause change the equation?

Toronto physician Jennifer Pearlman, MD, an Artemis guest, said the medication works best layered onto medical infrastructure: "GLP-1 is just part of the story. This must stack." She cited an observational Mayo Clinic study published this year: postmenopausal women on hormone therapy lost about 35 percent more weight on tirzepatide than women on the drug alone, though researchers noted it doesn't prove cause and effect.

By evening's end, Pearlman reframed the thesis entirely: "I disagree that it's a GLP-1 revolution. I think it's a four-factor revolution" — naming metabolic medicine, women's health, regenerative medicine and AI, and describing the field as "recognizing the ovary as the architect of female longevity."

Which treatments are already seeing demand?

Artemis CEO Simon Mansell said the GLP-1 effect shows in his numbers: "We are driving about 3,000 new patients into our clients per month now through the consumer advertising." Artemis offers Neogen, which uses nitrogen plasma energy for facial collagen, and T-Shape 2, combining radio frequency, low-level laser, vacuum and massage for body laxity.

San Diego dermatologist Tess Mauricio, MD pairs energy-based treatments such as CO2 laser or RF microneedling with platelet-rich plasma and, sometimes, exosomes. "I have patients who are in their 70s being put on GLP-1, and we do not see the Ozempic face, which to me is amazing for that age," she said.

Is filler still relevant?

Yes. New York dermatologist Amanda Doyle, MD, a Merz Aesthetics guest, explained rapid medication-related weight loss hits superficial fat pads, while age-related loss happens deeper. Merz expanded its Belotero line with FDA approvals in September for Belotero Volume (+) for the midface and Belotero Intense (+) for lips.

Austin oculoplastic surgeon Sheila Barbarino, MD told patients who fear filler post-weight loss: "If you place filler in the correct anatomical position, you should always, always, always look like you've lost weight and that you look more sculpted, not that you've gained it." New York dermatologist Marina Peredo, MD said biostimulators are having "a huge comeback."

Merz's DJ Sethares, vice president of U.S. marketing — whose portfolio includes Radiesse, Ultherapy and Xeomin — flagged the industry risk: "We are at this inflection point of risk because the innovation is outpacing the education." She called for shared standards: "I don't believe in starting with product first at all. I believe in starting with the patient first."

Are breast implants getting smaller?

New York plastic surgeon Anna Steve, MD, a Motiva guest, doesn't prescribe GLP-1s, "but probably more than 80 percent of my patients are on a GLP-1" — many not overweight to begin with. Volume loss stacks: pregnancy, perimenopause, then medication. "They almost get a second hit with perimenopause, and then a third hit with GLP-1," she said.

Motiva maker Establishment Labs has seen "the shift towards smaller volume implants," said Malavika William, and recently received approval for smaller sizes. Beverly Hills plastic surgeon Charles Galanis, MD confirmed patients now ask for the brand by name — specificity that didn't exist a few years ago.

What is the trust problem?

"I think actually the biggest problem is not influencers. I think it's actually other providers," said Galanis. Mauricio stressed that "discovery doesn't equal trust," especially as patients ask AI for treatment advice. Alan Durkin, MD, chief medical officer of VIO Med Spa, argued medspas are part of the answer: "Whether we like to admit it or not, they're a health-care delivery system, and they are here to stay."

Dayan closed with a lightning round on what history will write. Glaicar predicted the line between health and beauty will disappear: "It's going to be like, remember when we only did aesthetics?" Sethares had the last word, hoping her grandchildren will hear she helped "transform something that may have been perceived as superficial to something that is deeply meaningful."