Plastic surgeon Johnny Franco, MD, discusses how his firsthand experience with GLP-1s shaped his patient-centered wellness program and what plastic surgeons should know before adding similar treatments to their aesthetic practices.
As GLP-1 medications continue to reshape the conversation around weight loss, plastic surgeons are increasingly exploring how these treatments fit into long-term aesthetic care. In this interview, Johnny Franco, MD, a board-certified plastic surgeon, shares how his own weight loss journey influenced the development of a personalized, wellness-focused GLP-1 program at Austin Plastic Surgeon. His approach emphasizes medical oversight, patient education, and regular follow-up—offering a potential model for aesthetic surgeons looking to expand into this emerging space.
Plastic Surgery Practice: You’re known for taking a highly personalized, hands-on approach to GLP-1 treatments. What inspired you to take this route rather than the more traditional, prescription-only model?
Johnny Franco, MD: At Austin Plastic Surgeon, we’ve developed a unique and deeply personal approach to weight loss. A big part of that comes from my own journey—I’ve been on GLP-1 medications and have lost over 90 pounds over the past 3 years. For me, it was never just about getting a prescription. It was about making lifestyle changes, undergoing medical evaluations, and incorporating wellness treatments to improve my overall health. That personal transformation inspired our program. The goal isn’t just hitting a number on the scale—it’s about helping patients live longer and live better. There are many factors that go into wellness, and we’ve taken great pride in supporting our patients through every step of that journey.
PSP: Weekly patient check-ins are a cornerstone of your method. What do those appointments typically involve, and how do they help improve patient outcomes?
Franco: We typically see patients once a month, which strikes a good balance between accountability and flexibility for their lifestyle. Our providers are always available in between visits for questions or support, but these regular check-ins help us build a custom plan and then guide patients through it. Once we’ve set that plan in motion, it takes time to implement it successfully and make adjustments as needed. As we’ve evolved, we’ve seen that some patients may stay on GLP-1 medications long-term, depending on their goals and medical indications. For those who’ve reached a steady state, we can eventually stretch check-ins to every 3 months—and possibly longer in the future. It’s all about tailoring the follow-up to each patient’s journey.
PSP: In your experience, what are the most common challenges patients face when starting GLP-1 therapy, and how do you help them navigate those hurdles in real time?
Franco: GLP-1 medications have been game-changers in terms of wellness and longevity, but like any treatment, success comes down to setting the right expectations. Not everyone responds the same way, and that’s okay. In the past, people were in a rush to lose weight, but now we know that a steady, structured approach leads to better results. Patients tend to do best when they lose weight gradually, giving them time to adjust their habits, maintain muscle mass, and boost activity levels. We’ve learned that guiding patients with realistic milestones, ongoing support, and education helps them not only stick with the treatment but thrive on it. And as newer medications continue to roll out, we expect that journey to become even smoother.
PSP: For plastic surgeons who may be considering offering GLP-1 treatments in their practices, what systems or protocols would you recommend they put in place to ensure consistent monitoring and patient support?
Franco: Integrating GLP-1s or wellness programs into an aesthetic practice starts with a mindset shift—it’s not just about writing prescriptions; it’s about delivering a program. You need to define what that patient journey looks like in your practice. That includes creating treatment protocols, ensuring legal and FDA compliance, and putting systems in place for regular monitoring. This isn’t a one-size-fits-all solution. GLP-1s have been one of the most transformative medications I’ve seen in my career, but they’re not the right answer for every patient. Successful programs look at the whole picture—lifestyle, medical history, goals—and help patients navigate every step of their wellness journey.
PSP: As patients begin to lose weight with GLP-1 therapy, what role can plastic surgeons play in supporting their transformation through procedures or adjunct services?
Franco: Plastic surgeons are in a unique position to support patients as they transform, especially since many of them are new to aesthetics. GLP-1 medications are changing lives, but with that weight loss comes new aesthetic concerns—things like skin laxity, volume loss, and changes in skin quality. It’s important to educate patients about what to expect and what treatments are available. These patients often don’t know what options exist, so it’s up to us—as experts—to guide them and provide access to treatments that match how good they now feel on the inside.
PSP: Looking ahead, how do you see GLP-1 treatments fitting into the broader continuum of care in aesthetic medicine—and what role do you believe plastic surgeons should play in managing this evolving patient population?
Franco: GLP-1s are becoming an essential part of aesthetic medicine. We’re already seeing major companies invest in next-generation versions of these drugs, and that’s only the beginning. At our practice, we’ve coined a phrase—the “Ozempification of Aesthetics”—because we’re seeing young patients with mature concerns, from facial volume loss to skin laxity. As plastic surgeons, we have a responsibility to help these patients complete their transformation—not just by helping them look good, but by creating long-term aesthetic plans that match their new lifestyle. This is a new kind of patient, and a lifelong opportunity for providers who are ready to guide them. PSP
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