Do you use semaglutide (Ozempic, Wegovy, Rybelsus), liraglutide (Saxenda, Victoza) or tirzepatide (Mounjaro)? This group of medicines, also known as GLP-1 agonists, is being used more and more, both for diabetes and for weight loss. For an eyelid surgery this is relevant to report, especially with regard to gastric emptying.
Which medication does this concern?
- Semaglutide: Ozempic, Rybelsus (tablets), Wegovy
- Liraglutide: Victoza, Saxenda
- Tirzepatide: Mounjaro
- Dulaglutide: Trulicity
Why is this relevant?
GLP-1 agonists slow down gastric emptying. This contributes to the feeling of satiety and helps with weight loss, but also means that in some people, despite normal fasting according to the guidelines, food may still be present in the stomach [1,2,3].
This is especially relevant with sedation or general anaesthesia, where there is a risk that stomach contents end up in the airways (aspiration) [1,4,5]. With procedures under local anaesthetic, such as an eyelid correction, this risk is considerably lower, because you remain conscious and protect your own airway [4].
Still, it is important for us to know whether you use this medication, particularly if you suffer from nausea, a bloated feeling, or if you have recently started the medication or the dosage has been increased; in those situations the chance of delayed gastric emptying is greatest [3,4].
Discuss it in a personal consultation with plastic surgeon David Jairath, at our clinic for eyelid surgery in Haarlem. A first consultation can usually take place within a week.
Points of attention
- GLP-1 agonists slow down gastric emptying, particularly shortly after starting or increasing the dosage [3,4]
- With local anaesthetic (as with an eyelid correction) the risk is considerably lower than with sedation or anaesthesia [4]. At Kliniek het Bolwerk we always do eyelid corrections under local anaesthetic.
- Do you suffer from nausea, a bloated feeling, vomiting or a full feeling? Always report this on the day of the procedure
Our protocol at Kliniek het Bolwerk
1. Extensive medical history
We ask about the use of Ozempic, Wegovy, Saxenda, Mounjaro or comparable medication, and how long you have been using it or when the dosage was last adjusted.
2. Asking about stomach complaints
We ask specifically about nausea, a bloated feeling or vomiting in the days before the procedure [3,4].
3. No routine stopping
For an eyelid correction under local anaesthetic, stopping GLP-1 agonists is, as a rule, not necessary, given the low aspiration risk with this form of anaesthetic [4]. If in doubt, we consult with your treating doctor.
4. Adjusting with stomach complaints
Do you suffer from a full feeling or nausea on the day of the procedure? Then we discuss whether it is wise to reschedule the procedure [3].
Important: are you using Ozempic, Wegovy, Saxenda, Mounjaro or comparable medication? Always report this, even though the risk with an eyelid correction under local anaesthetic is limited. If you suffer from nausea or a full feeling, then definitely report this on the day of the procedure.
When do we advise against the procedure (for the time being)?
- In the case of active stomach complaints such as nausea, vomiting or a strong full feeling on the day of the procedure [3,4]
- Shortly after starting or increasing the dosage, in combination with stomach complaints
Our advice
Are you using a GLP-1 agonist such as Ozempic, Wegovy or Mounjaro? Report this during the intake consultation at Kliniek het Bolwerk. If you have stomach complaints on the day of the procedure, then contact us beforehand.
Literature references
The publications below form the medical-scientific basis of this article:
- American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients on GLP-1 Receptor Agonists. American Society of Anesthesiologists. 2023. https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative
- Anesthesia Considerations for a Patient on Semaglutide and Delayed Gastric Emptying. Cureus (PMC). 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10438952/
- Should glucagon-like peptide-1 receptor agonist treatment be withheld in preoperative management? PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509509/
- Should glucagon-like peptide 1 receptor agonists be withheld during the preoperative period? Cleveland Clinic Journal of Medicine. 2025. https://www.ccjm.org/content/92/4/209
- New Multi-Society GLP-1 Clinical Practice Guidance Released. American Society of Anesthesiologists. 2024. https://www.asahq.org/about-asa/newsroom/news-releases/2024/10/new-multi-society-glp-1-guidance
