Nothing gets us more excited than talking about a not-so-little tweakment or a nip-tuck procedure. In the spirit of transparency, Marie Claire’s aesthetics column, Life in Plastic, delivers a first-hand peak into what goes on behind the doctor’s door.
I always joke that I was Ozempic’s patient zero. In 2020, my endocrinologist, Dr. Anna Kausel, wrote me a prescription for the GLP-1 medication, which at that point, I had never heard of. But my Columbia-trained physician believed it was the smartest option for my medical history, weight, and bloodwork. I got it approved through insurance and started weekly injections. One year later, I had lost 65 pounds on the lowest dose. It changed my life. It changed my health. And, perhaps most unexpectedly, it changed my body image for the better.
I’m not going to pretend that Ozempic—and the way our culture has co-opted it—is without fault. It’s often misused, sometimes prescribed without proper oversight, and, in many ways, has ushered back in the waifish beauty standards of the late ’90s. But what I can offer is my own experience: that of someone who was an appropriate candidate for the medication and who, today, has the most peaceful relationship with food and her body that she’s ever experienced.
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What no one really tells you about significant weight loss is how disorienting it can be to settle into your “after.” The physical transformation happened for me in just 12 months, but my psychological recalibration lagged way behind. For years, I reached for clothes that no longer fit, as if muscle memory hadn’t gotten the memo. And just as my mind began to catch up, I found myself almost resentful of the stretch marks and loose skin that remained.
Here’s my truth: two opposing feelings can coexist. I am proud of what I’ve accomplished. I feel stronger, healthier, and more at home in myself than ever before. And yet, I don’t want to wear the proof of that transformation so visibly.
My arms were my biggest pain point. No matter how often I did Pilates, lifted weights, or followed along with Gabby George’s arm workouts, they didn’t change. They looked, to me, like “Ozempic arms”—looser skin, a small pocket that wouldn’t tighten—despite everything I was doing. I would avoid tank tops and constantly throw a sweater over my shoulders, even in the middle of summer. I just wanted my arms to look like arms.
I finally decided to book a consultation with an aesthetics professional—though I wasn’t entirely sure for what. A laser? A brachioplasty? Liposuction? I went in with an open-mind. Here’s how I ended up addressing my “Ozempic arms” and the treatments that were ultimately right for me.
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The Consultation
Going into my consultation this past May, I thought I was going to need a braichioplasty—a Big Deal surgery that removes excess skin and essentially leaves you with a scar from your elbow to armpit. My issue was more skin laxity than excess fat, so I genuinely didn’t think liposuction would be sufficient; I’d just be left with flabby skin, right? Dr. David Shafer, my incredible (!!) plastic surgeon and founder of Shafer Clinic in New York City, quickly debunked that.
He said that there was a new laser that recently hit the market called Renuvion, and when used in tandem with traditional liposuction, can be incredibly effective at snapping the skin up and contouring existing muscle. It’s a form of “lean lipo” that’s more focused on sculpting than fat reduction. “The Renuvion plasma skin tightening allows us to remove more fat while maintaining and enhancing tighter skin, while lowering the risk of resulting in loose skin,” Dr. Shafer explains. “The best example is the helium ball in a science museum. When you place your hands on the glass ball, you see light reaching from the center to your hand. The same effect occurs with Renuvion.” In short, medical-grade helium and plasma energy tighten the skin with thermal and mechanical power, while also stimulating collagen through medical-grade helium infusion and the application of plasma energy. He also wanted to tack a Genius Radiofrequency laser onto the skin to help improve the dimpled texture and stretch marks. The three-prong approach would leave me with four little scars: two on my inner arm and two on my outer elbow.
But the part of the consultation I appreciated most was Dr. Shafer being super honest with me about what kind of results I could expect. Plastic surgery is not a miracle worker, so we’re chasing an improvement from my baseline, not manufactured perfection. He explained that while a brachioplasty would tighten all my skin and remove the upper arm bulge I wanted gone, the recovery is much more intense, and the scar would be pretty huge. Our plan of attack was a bit more conservative, and I might still have a bit of loose skin, but recovery and scars would be minimal. You can always go back and do more, he said, but you can’t go back and do less.
Without further ado, I booked my appointment for October 23. I wanted to wait until summer was over so that I could give my arms time to heal during long-sleeve season.
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My Pre-Op
I went in for my pre-op about a month before surgery. It’s pretty straightforward: I signed some papers, we went over instructions for the weeks leading up to surgery (stop semiglutide, don’t use Tylenol, start arnica, order compression garments), and instructions for the immediate days leading up to surgery (wash my body with the provided anti-bacterial soap, pick up my pain meds and antibiotics). It’s a little bit of information overload, but my nurse (hi, Amy) typed everything up for me to reference.
Day Before Surgery
I’m a queen of compartmentalization, so I honestly didn’t give too much thought to anything until it was time to start prepping. I reread my instructions and made sure to shower twice that day using antibacterial soap. I also took one dose of preemptive pain medication, as that’s Dr. Shafer’s protocol, but always listen to your physician.
Morning of Surgery
When I woke up, the first thing I did was jump in the shower and wash with anti-bacterial soap (again!) and then take a Zofran to prevent nausea from anesthesia. My parents came to pick me up and brought me to Dr. Shafer’s office. I changed into my surgical gown, compression socks, and put my hair in a cap (don’t forget a hair tie as I did!). Then, Dr. Shafer took a purple Sharpie to mark the areas on my arm that he wanted to focus on. He actually has a surgery center in his office, so I literally just walked right in and climbed onto the operating table. It was a very laidback, calm environment, and I felt incredibly taken care of. The anesthesiologist had me knocked out within seconds, and I woke up in the recovery room—groggy, but with it.
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Day One of Recovery
Honestly, I think I forgot that liposuction was actually surgery. Maybe it’s because I work in an industry where I’m talking about procedures and facelifts and tummy tucks constantly, but liposuction seemed like it would be easy. And don’t get me wrong, recovery wasn’t horrible, but at the end of the day, it’s still surgery.
I was wrapped in so much gauze on day one that my sister had to feed me and hold water with a straw up to my mouth. The rest of that day is honestly a blur. I was pretty out of it and slept probably 16 hours. PSA: If your feet are bothering you, take off your compression socks before bed. I left mine on for too long and woke up in the middle of the night with crazy foot pain.
Day Two Recovery
When I woke up on day two, it was time to take off the 19,000 layers of gauze and switch into my compression garment. “The compression helps reduce swelling and also keeps the skin smooth and pressed up against the underlying muscle and remaining fat,” explains Dr. Shafer. “Good adherence is important for the final result.”
I had my sister help me unwrap everything and pull the gauze off the incisions, which were held together by small stitches. It was relatively easy, but we accidentally pulled out one of the stitches, and fluid shot onto the floor. I naturally freaked out, but a quick text to my medical team assured me everything was ok. I was able to hop in the shower, apply my prescription antibacterial cream to the incisions, and get into my compression garment.
I wasn’t really in any pain—discomfort, if anything. My body was pumped with so much fluid during the liposuction, so I felt incredibly bloated and distended, not just in my arms, but my stomach as well. I slept on and off; I had to be on my back with my arms elevated on pillows took small walks around the house.
Day two is when I started to notice one of the most bizarre side effects. I would move ever so slightly and think that my incisions were gushing fluid. Any movement made me feel like Niagara Falls was inside my arm. Rushing waves of cold fluid would brush against my skin, and I was constantly patting down to see if my arms leaked. They didn’t—it’s a normal post-lipo side effect that I just hadn’t heard about or expected.
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Day Three and Four
By day three, it was time for me to get my first surgical lymphatic drainage massage. I was so ready to get the fluid moving; my arms felt like two hot-air balloons. My nurse, Amy, connected me with the amazing Zulema (she’s strictly word of mouth bookings, but if you’re in the Tri-State area and interested, send me a DM and I’ll connect you). She came to my apartment with all her tools and got to work, using gentle massage movements to push the fluid toward my lymphatic sites. It’s not necessarily a pleasant experience, but I felt less like a sumo wrestler when we were done. She also showed me three stretches I should do on myself twice a day: pulling my arm across my body, massaging it up and down while it’s raised, and pulling it behind my back. They were a little painful to execute, but they definitely gave me more mobility.
One big thing that shocked me: I was barely bruised. My arms were red for sure from the laser, but I didn’t have the intense and dark bruising I experienced when I had my bra roll liposuction during my breast reduction. “The tumescent solution and anesthesia have advanced greatly over the last several years,” explains Dr. Shafer. “We also add a special medicine to the tumescent called TXA, and we have seen significant decreases in bruising after incorporating TXA into our protocol.”
Samantha Holender’s arms four days post-op. The redness is from the Genuis RF laser.
(Image credit: Samantha Holender)
Day Five to Seven
Ok, here’s where things started to take a turn. Candidly, I thought I would be fully back in action by Tuesday (surgery was the prior Thursday), but I was sorely mistaken. Don’t get me wrong, I was able to function without help. But walking a few blocks to the pharmacy left me super swollen and exhausted. I was never in any pain, but too much action or periods without elevation left me very uncomfortable. In retrospect, I should have taken off a week of work and canceled my plans.
I also panicked when I looked at my arms. I noticed that my armpit looked huge and chunky, and that I had cyst-like balls covering the underbelly of my upper arm. All of that is totally normal—it’s a reaction to the fluid in my body and the lipo—but it’s definitely something I wish I knew about beforehand. “It’s little pockets of swelling. The compression, massage, and time lead to the resolution of these areas. They may even shift or change in size throughout the day for the first several weeks,” says Dr. Shafer. (It does go down; four months out, my armpits are back to normal, and I only have two granules left.)
Days 8 to 14
I had a one-week check-in with Dr. Shafer, and he confirmed that everything was looking great. He gave me permission to spend a few hours a day without my compression garment, although I honestly felt better when I was wearing it, so I did that pretty consistently through the end of week two. I had another session with Zulema during this period—she wrapped my whole body in Saran to help with the post-surgery bloating. I was also able to restart my GLP-1.
The big turning point for me came around day 10—I went out to dinner with friends for the first time (I was very ready to go home afterward) and took a few strolls around my neighborhood. But overall, I started to feel more capable and back to myself. Was I walking more than 4,000 steps a day? Absolutely not. But by and large I was able to get through a day of work.
One Month Post-Surgery
By the time I was four weeks out, I started to notice a huge difference. The pocket of fat that hung around my upper arm was completely gone. My expectations going into the surgery were very realistic, so I was overwhelmed by how significant a difference the three-pronged approach made. Not only did the swelling start to go down, and I began to see just how different my arms were going to look, but I also started wearing my compression garment only at night, switching from a size medium to extra small as the swelling went down. (While the garment is comfortable, it does lie kind of funky under clothing.)
By my four-week check-in, my stitches had all dissolved or fallen out, and I stopped using the antibiotic ointment. My bruising had also entirely dissipated. After Dr. Shafer checked everything out, I had an appointment with. Lucia Miranda, LE, CCMA, a licensed aesthetician and certified clinical medical assistant in his practice, to start the first of roughly six laser treatments on my incisions. She used a Pulse Dye Laser, and the treatment took all of five minutes. It just feels like a rubber band snapping against my skin, but it has made a huge difference in both the color and texture of my scars.
Two Months Post-Surgery
It’s around the six- or seven-week mark when I started to feel totally back to my norm. I was working out again—everything still felt tight (almost like a tension band was permanently sewn into my upper arm), but I could move around without having my arms blow up and swell. I stopped sleeping with the compression garment and could sleep on my side or stomach again. The whoosh of cold fluid inside my arms totally went away. And, most importantly, I started to see a massive difference.
My arms were probably half the size they were pre-lipo, which was crazy, and a lot of the swelling had subsided. That being said, I still wasn’t comfortable wearing a tank top—the underbelly of my arm still had the telltale signs of bands and granules.
These are the bands and cysts. They shrunk tremendously over time, but I still have some lingering.
(Image credit: Samantha Holender)
Three Months Post-Surgery
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By the time I hit the three-month mark, I found myself staring at my before-and-after photos in disbelief. The difference is not only in the size of my arms, but also in the shape. Dr. Shafer was able to contour my arms in a way that emphasized the muscles and created the appearance of toned, shapely definition.
I do have a little loose skin at the top of my right arm that didn’t snap up completely, so we’re talking about doing one more Genius RF treatment to help with the laxity. But frankly, I’m so over the moon with my results that I barely notice it. My sleeves are so much looser across the board, and I’m constantly reaching for workout sets or tops that used to leave me feeling self-conscious. The best part: the results will only become more pronounced as I near the six-month mark.
The Takeaway
My arms look like normal arms, not weight loss arms, which is exactly what I wanted out of this procedure. I’m the first to admit that all the talk of “Ozempic Body” has gotten out of hand (do we really need GLP-1 skincare?), and it’s being pushed in “fix it” ways that feel like a money grab. But it’s not all snake oil. There’s something really powerful about putting the chapter of my life where I felt trapped in a body that wasn’t mine officially behind me and not having to stare that storyline in the mirror every single day.
Getting my arms done was easily the best thing I’ve ever done for myself. Healing might not have been as speedy as anticipated, but I’d go through it all over again for these results.
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Meet the Expert
Dr. David Shafer
Dr. David Shafer is a double board-certified plastic surgeon renowned for his expertise in aesthetic surgery and personalized, innovative patient care at Shafer Clinic.
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