Breast augmentation, HPV and semaglutide - Any concerns?

Question

Hi, I’m a 40-year-old Latina woman, 165 cm tall, with a medium complexion. I’ve been on a weight loss journey with diet and semaglutide since August and am now 10 pounds away from my goal of 155 pounds. I’m planning a breast augmentation and wanted to ask: 1. Are there any risks since I’m an HPV carrier (no symptoms, cleared by a LEEP in Dec)? 2. Any concerns about stopping semaglutide? Thank you so much.

Donovan Rosas, MD · Answer

Most recommend stopping semaglutide at least 1 week pre-op.

That being said, it is important to reach a healthy stable weight pre-op. If currently on semaglutide, patients should be confident that they have stabilized before pursing surgery.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Danielle Dumestre, MD · Answer

Hello! 
The HPV will not have any affect over your breast augmentation. Yet, the semaglutide I would recommend stopping at least 2 weeks before and 2 weeks after surgery. For many reasons, one is decrease is healing and second is the medication delays gastric emptying which can be an issue for anesthesia while intubating you and you develop reflux, can aspirate at that time. Every surgeons recommendation for a timeline on stopping semaglutide varies.

George Volpe, MD · Answer

congratulations on getting close to your goal weight. The HPV should play no role in breast augmentation. The concerned with semaglutideis mostly related to anesthesia. Most anesthesiologists would request that you stop these type of medications 2-3 weeks prior to your surgery. Since these medications slow down emptying of your stomach into the intestines, there may be possibly food in your stomach at the time of general anesthesia with the risk that the food could travel backwards up the esophagus and into the trachea and cause an aspiration pneumonia. Therefore, stopping at least two weeks prior. Be sure to let both your surgeon and anesthesiologist know that you have been on this medication. Also, if you have not met with a plastic surgeon yet, be honest about your weight loss and also your goals. Also be honest to yourself, whether you think you will regain weight once you are off the medications or have you committed yourself to a new diet/lifestyle. Significant weight loss can play a role in breast augmentation. The inframammary fold tends to loosen. If your weight loss has been very significant, discuss with your plastic surgeon how he or she is going to manage the fold.

Daniel Barrett, MD · Answer

Dear Bluemoonh,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ellen Ozolins, MD · Answer

Thank you for your question. HPV is not a direct concern when it comes to breast augmentation; it will not impact your surgery or recovery. However, Semaglutide can influence gastric emptying, which may affect anesthesia and your recovery process. Your surgeon and anesthesiologist might recommend stopping Semaglutide 1 to 2 weeks before your surgery. This precaution helps reduce the risk of aspiration during anesthesia, minimizes nausea and vomiting after the procedure, and ensures stable blood sugar levels post-operatively.

Payman Danielpour, MD, FACS · Answer

No concerns, just stop your ozempic 2 weeks before surgery.  There is no concern for the HPV at all.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Brian Widenhouse, MD · Answer

Thanks for your question. There should be no issue regarding HPV; however, please discuss the semaglutide use with your plastic surgeon. Most surgeons require a patient to be off of semaglutides for  a least two to four weeks prior to having a cosmetic procedure. This is something you definitely need to talk about before scheduling.
Best of luck!

Eric W. Anderson, MD · Answer

Great questions ! 1. no risks, especially since cleared 2. I have my patients stop medical weight loss injections 2 weeks before and 2 weeks after surgery

James Knoetgen, III, MD · Answer

Congrats on your weight loss journey – you’re so close to your goal! Here’s what you need to know: 
1. Breast Augmentation and HPV 
Being an HPV carrier (with no symptoms and recent clearance via LEEP) doesn’t pose direct risks for breast augmentation. Just make sure you’re in good health overall and continue regular gynecological checkups.
2. Stopping Semaglutide
•	It’s usually recommended to stop semaglutide 1-2 weeks before surgery to avoid issues like delayed stomach emptying during anesthesia. Check with your surgeon and prescribing doctor for specifics. 
•	After surgery, stick to your healthy eating habits to avoid weight fluctuations until you can restart it. 
Quick Tips: 
•	Focus on protein-rich meals and stay hydrated to support healing. 
•	Avoid smoking or alcohol before surgery to ensure the best recovery.

You’re on a great track – good luck with your procedure!

Breast augmentation, HPV and semaglutide - Any concerns?

Answers (12)

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