As a board-certified plastic surgeon based in Austin, Texas, Dr. Johnny Franco has dedicated his career to helping patients achieve their aesthetic goals while prioritizing their overall well-being. He recognizes that true, lasting beauty emanates from a foundation of health and wellness, a philosophy that fuels his passion for empowering individuals to achieve optimal physical condition. This deep commitment to holistic well-being led him to develop Biohacking Beyond Beauty, a program that integrates cutting-edge medical advancements with a holistic focus on lifestyle changes.
Ailm Atelier recently sat down with Austin plastic surgeon Dr. Franco to discuss his innovative approach to weight loss and wellness. Dr. Franco shared his personal journey and the inspiration behind his Biohacking Beyond Beauty program.
Interviewer:
Dr. Franco, tell us about your background as a plastic surgeon as well as your personal experience with weight loss medications and the significant impact they’ve had on your health.
Dr. Franco:
I’ve been in practice for about 10 years and moved to Austin about seven years ago to start my practice. My weight loss journey resonates with many people because it’s a journey that many have experienced themselves. I was very athletic in high school and even played football in college. But, like many others, life happened, and I gained some weight. During the pandemic, like so many, I gained even more. It was really my birthday in 2022 that served as a wake-up call.
Around that time, an article in the New England Journal of Medicine came out about GLP1 medications and weight loss. This article gave me the evidence-based confidence to try these medications myself. I’d tried other diets and weight loss methods before, but they never really stuck. With the GLP1 medication, I lost 90 pounds in about nine months. It’s been three years since then, and I’ve maintained that weight loss.
Interviewer:
What are the core principles of your weight loss program, Biohacking Beyond Beauty, and how does it help patients achieve their wellness goals?
Dr. Franco:
When we first introduced GLP1 medications into our practice, we anticipated that they would be beneficial for our surgical patients and others. But, as you know, weight is something that affects nearly everyone, either personally or through someone they know. We quickly realized that the medication was just the jumpstart. It’s revolutionary, the most impactful medication I’ll see in my lifetime, affecting so many people. But it’s not the whole story.
Biohacking Beyond Beauty evolved from that realization. We now offer a comprehensive program that includes everything from in-depth lab testing to personalized dietary guidance. We utilize some really innovative AI tools that help patients track their metabolic output, analyze their food intake, and even count macros. It makes the process much easier. We also offer phenome testing to help patients understand the root causes of their habits, and these types of tests will only continue to improve.
Interviewer:
Can you describe a typical patient’s journey through your weight loss program, from initial consultation to achieving their weight loss goals and beyond?
Dr. Franco:
A patient’s journey with Biohacking Beyond Beauty begins with a comprehensive consultation. We discuss their goals, medical history, and lifestyle. We emphasize the importance of commitment and setting realistic expectations, explaining that it takes a minimum of six to nine months to truly establish new habits and make lasting changes. This is a key distinction between GLP1 medications and previous weight loss drugs. GLP1s don’t just offer a quick fix; they fundamentally change your relationship with food.
While many people focus on the initial side effects like reduced appetite and stomach fullness, the real magic happens over time. As those initial side effects subside, what remains is a profound shift in cravings. You can walk past things that used to tempt you and simply not feel that pull anymore. That’s where the real transformation lies.
We encourage patients to use this opportunity to make changes in their home environment and establish healthier eating habits. To support this, we incorporate tools like the Lumen device, which allows patients to track their metabolic output and see how even small changes, like adjusting their dinner time, can impact their metabolism. We also utilize AI-powered apps that analyze food intake and make personalized nutritional recommendations, making it easier than ever for patients to track their diet and make informed choices.
One of the key realizations we’ve had is that weight gain is often multifactorial. We’ve integrated an internal medicine doctor into our program to address underlying health conditions that may be contributing to weight gain, such as medication side effects or hormone imbalances. Sometimes, it’s a matter of adjusting medications or addressing hormonal issues in conjunction with the GLP1s to optimize results.
Interviewer:
You mentioned the potential for “secondary changes” like skin laxity and volume loss, sometimes referred to as “Ozempic face.” Can you elaborate on this phenomenon and what can be done to address it?
Dr. Franco:
One of the things we’re observing as more people utilize GLP1 medications for weight loss is the potential for changes in facial appearance, sometimes referred to as “Ozempic face” or “Ozempic neck.” This phenomenon is characterized by loss of volume and skin laxity, which can make people appear older. It’s important to understand that this is not a direct effect of the medication itself, but rather a consequence of rapid and significant weight loss.
When we lose fat, we lose it all over, including in the face. This can lead to a hollowing out of the cheeks, temples, and under-eye area, as well as sagging skin. While some people may appreciate the slimming effect on the face, for others, it can be a source of concern.
The good news is that there are ways to address these changes. Firstly, it’s crucial to maintain a healthy diet and hydration, as these factors play a significant role in skin health. Topical skincare products containing ingredients like retinoids, hyaluronic acid, and peptides can also help improve skin elasticity and stimulate collagen production.
For those seeking more noticeable improvement, there are a variety of non-surgical and surgical options available. Non-surgical treatments like fillers and lasers can restore volume, tighten skin, and improve texture. In some cases, surgical procedures like facelifts or neck lifts may be considered to address more significant laxity.
We’re fortunate that several major industry partners are actively researching and developing new treatments specifically designed to address the facial changes associated with weight loss. We anticipate seeing some exciting new developments in this area in the near future.
Interviewer:
Dr. Franco, you’ve spoken about the rise of a “wellness wave.” Can you elaborate on some of the key trends you’re seeing in the industry and how these trends are influencing your practice?
Dr. Franco:
Patients often start with a focus on weight loss, but as they begin to feel better, they naturally progress to asking, “How else can I improve my health?” We’ve seen a surge in interest in hormone therapy, regenerative medicine, and other biohacking techniques. It’s an exciting time because regenerative medicine, which was once considered somewhat fringe, is now backed by solid scientific data. This convergence of patient demand and evidence-based treatments is huge.
Initially, our goal was to get everyone off the medication once they reached their target weight. However, the evidence is mounting for the benefits of long-term, low-dose use for certain individuals, especially those with a family history of heart disease, sleep apnea, or other conditions. We’ll see more and more people using these medications long-term for reasons beyond just weight loss.
From the aesthetic perspective, we’re also anticipating seeing patients who experience secondary changes like skin laxity and volume loss, even if they weren’t initially on the medication for weight loss. Several major industry partners are already conducting clinical trials to address these subsequent changes, and we should see some results later this year.
Interviewer:
Can you recall a patient encounter that deeply moved you and helped shape how you approach your work?
Dr. Franco:
There’s one particular patient encounter that deeply resonated with me. She was a business acquaintance who later became a friend. She had gained a significant amount of weight after having children and was constantly traveling for work, making it challenging to maintain a healthy lifestyle. She had tried countless diets and was understandably skeptical when I suggested GLP1 medications. She was tired of getting her hopes up, only to be disappointed.
After some initial hesitation, she decided to give it a try. A year and a half later, she wrote me the most heartfelt and detailed review I have ever received. She described how she had come to the initial consultation with no hope, defeated by years of failed attempts. She didn’t want to believe that anything could work, and she was afraid of being disappointed again. But she decided to take a chance, and it transformed her life.
I saw her recently, and she still looks fantastic. She reminded me of that initial consultation and said that stepping into my office that day was the best decision she ever made. It’s been three years, and she still feels that strongly about it.
What’s remarkable is that her experience is not unique. We receive more heartfelt testimonials from our weight loss patients than from any other procedure we offer. It’s an incredibly emotional journey for them, and it’s been an emotional journey for me as well. These encounters underscore the profound impact that weight loss can have on a person’s life, and they reinforce my commitment to providing compassionate and effective care.
“I started on the Skinny Shot in February 2023, so I’ve been on it for two years. I took Semaglutide for about 15 months, and I lost 65 lbs. Then I switched to Tirzepatide and lost another 30 lbs. So, my total…is 91 lbs. I went from 280 to 189…in two years. It’s been unexpected, surprising, rewarding, both mentally and physically, and sometimes challenging but worth it” – E. Sheie
Interviewer:
What key takeaways do you hope Ailm Atelier readers will gain from what you have shared with us today?
Dr. Franco:
I hope readers will understand that this is truly different from anything they’ve tried before. It’s not just another diet or weight loss fad. It’s an investment in their future health and well-being. These medications have the potential to make a dramatic and lasting impact on people’s lives, not just in terms of weight loss, but also in terms of overall health and longevity.
The biggest obstacle we encounter is often the skepticism that comes from years of failed attempts. People are understandably hesitant to get their hopes up again. But I want to assure them that this time is different. The science is sound, the results are real, and the potential for transformation is immense.
It’s not just about living longer; it’s about living better, with more energy, vitality, and confidence. I encourage everyone to embrace this opportunity to take control of their health and unlock their full potential.
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