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Janet Chao, MD
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Restore SD Plastic Surgery»Blog » Semaglutide & Tirzepatide: Your Questions about Weight Loss Injections, Answered

Semaglutide & Tirzepatide: Your Questions about Weight Loss Injections, Answered

Published October 4, 2024 by Katerina Gallus, MD FACS
Woman taking measurements of her body in front of the mirror in her bedroom
  • Do I perform the weekly injections, or can you do it for me?
  • Should I microdose GLP-1 agonists like semaglutide?
  • What will my appetite be like on weight loss injections?
  • Do I need to stop semaglutide before plastic surgery? How long does it stay in your system?
  • What happens if you skip a week of Ozempic?
  • What is Ozempic face, and should I be worried about it?
  • Should I avoid high-sugar foods while taking GLP-1s?
  • What should I NOT eat while on semaglutide?
  • How do I manage nausea when on weight loss injections?

In recent years, semaglutide and tirzepatide, marketed under brand names like Ozempic and Wegovy, have emerged as promising solutions for weight loss. These injectable medications are well-known for their effectiveness, so many patients have questions about them! From how each works to what to expect while taking them, we’re here to answer all of them.

Do I perform the weekly injections, or can you do it for me?

You have options! You may perform your weekly injections at home, or visit our plastic surgery clinic to have them administered by Dr. Katerina Gallus and our team. If you prefer to do it at home, rest assured we’ll show you how and you will have easily self-injectable, pre-filled syringes.

Should I microdose GLP-1 agonists like semaglutide?

While there is no official agreement about what constitutes a “microdose” of weight loss injections, it may help to minimize side effects if you either (1) start with a smaller dose, or (2) administer your full weekly dose in stages throughout the course of a week. For example, some patients who self-administer injections may benefit from dividing their dose in half, performing injections twice weekly.

These techniques should be overseen by your physician, however; you should only take your medication as prescribed. In most cases, the reason we would recommend this “microdosing” technique is to minimize side effects, as gastrointestinal side effects can be common with GLP-1 agonists.

Note that it is critical to take a therapeutic level of the medication in order to see weight loss results, and we do not recommend stopping the medication for weeks before you reach your goal weight (another proposed definition of “microdosing”). It is routine to increase the dosage of weight loss injections after about 4 weeks, so we may need to increase your dosage in order to see effects. You will meet with Dr. Gallus on a monthly basis (or as needed), so we can address any concerns and adjust your medication as needed at that time!

Microdosing GLP-1 agonists for other conditions

While influencers like Dr. Tyna Moore have sparked a discussion online about using semaglutide and tirzepatide off-label for conditions like autoimmune disease, GLP-1 agonists are only studied and FDA-approved for certain uses, including for weight loss. We do not recommend self-medicating for other conditions with weight loss injections, even if you have read anecdotal evidence online suggesting that it may have other health benefits. Dr. Gallus offers these medications for weight loss because they are proven effective for this indication by numerous well-designed research studies—not because of their popularity for weight loss. 

What will my appetite be like on weight loss injections?

You will have a much smaller appetite than usual, and will likely find that you feel full after eating smaller portions. This is because semaglutide works by mimicking a hormone that targets areas of the brain involved in appetite regulation, so your appetite will naturally decrease over time. You will also experience fewer cravings, the most notable of which is often a reduced interest in high-calorie, sugary, or unhealthy foods.

Do I need to stop semaglutide before plastic surgery? How long does it stay in your system?

Yes, we recommend pausing semaglutide before undergoing anesthesia and surgery to avoid any complications. 

Semaglutide can remain in your system for 5 weeks or more after your last dose, so it is important to make your surgery plan with your weight loss plan in mind; be sure to discuss your weight loss medication with us well in advance of your plastic surgery procedure with your surgeon to establish a safe timeline for discontinuing use.

What happens if you skip a week of Ozempic?

Missing a dose of semaglutide is generally not a cause for concern, but it’s important to resume your next injection as soon as you remember if it hasn’t been more than 5 days. You may not experience as strong of a benefit from the medication after missing a week, but you can usually pick up right where you left off once the next dose is administered. 

If it has been more than 5 days, skip that dose; simply pick back up with your weekly injections on the next planned day.

If you miss more than one dose, give us a call so we can provide you with personalized guidance.

Close up profile view of woman pinching extra skin on neck

What is Ozempic face, and should I be worried about it?

“Ozempic face” is a colloquial term referring to a gaunt facial appearance that has been reported after significant weight loss on weight loss injections. Rapid fat loss naturally may cause the face to look more gaunt or aged, as the skin may not have enough collagen and elastin (the building blocks of skin elasticity) to bounce back when your body shrinks with weight loss. 

If you’re concerned about facial volume loss, working with a San Diego facial plastic surgeon for your semaglutide treatment provides a secondary benefit: we can discuss cosmetic treatments (such as fillers, San Diego facelifts, fat grafting, or laser skin tightening) that can to help restore lost volume and rejuvenate your appearance after weight loss injections! 

Learn how Dr. Chao treats Ozempic face »

Should I avoid high-sugar foods while taking GLP-1s?

Yes, you should avoid high-sugar foods when taking weight loss medications. While there are no hard and fast restrictions to what you can eat on the medication, you can optimize semaglutide’s effectiveness with a nutrient rich, whole foods diet. High-sugar foods can undermine the progress you’re making by increasing blood sugar levels, and they may also lead to a quicker return of hunger after eating. 

We recommend that our patients proactively aim for a nutrient-dense diet of mostly whole foods to make sure you get all of your nutrition while eating smaller meals. Starting this regimen while taking weight loss injections can help you get a running start and stick with these positive habits long-term!

What should I NOT eat while on semaglutide?

While no specific food is contraindicated because of a potential reaction with semaglutide weight loss injections, to achieve success with a medical weight loss program, it is best to eat less of certain foods and follow a balanced diet plan.

Foods to avoid:

  • Processed foods high in sugar or refined carbohydrates
  • Sugary beverages like soda or energy drinks
  • Fried foods that are high in unhealthy fats
  • Highly processed snacks, such as chips or pastries

Foods to eat:

  • Lean proteins like chicken, fish, beans, and plant-based options
  • Vegetables and whole grains that are fiber-rich
  • Healthy fats, such as those found in avocado, nuts, and olive oil
  • Low-sugar fruits like berries

How do I manage nausea when on weight loss injections?

There are several simple guidelines that you can follow to help prevent nausea:

  • Stay hydrated throughout the day
  • Eat smaller, more frequent meals
  • Avoid greasy or spicy foods
  • Try stomach-soothing teas like ginger

If nausea persists or worsens, you can always talk to Dr. Gallus about additional options, such as adjusting your dosage.


Are you interested in learning more about semaglutide for weight loss in La Jolla and San Diego? We’d love to talk! As a board-certified plastic surgeon, Dr. Katerina Gallus believes it’s essential to answer patients’ questions and educate you about all of your options before proceeding with any treatment or procedure.

Call Restore SD Plastic Surgery at 858-224-2281 to start the conversation today.

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