GLP1 agonists, Ozempic, Wegovy, and Mounjaro, were originally developed for managing type 2 diabetes, and have emerged as a groundbreaking tool for weight management. With the drug’s unique ability to significantly reduce weight, GLP-1s have gained popularity among those looking to shed extra pounds. However, while their benefits for weight loss are widely celebrated, they also come with an unexpected side effect often referred to as Ozempic Body or Ozempic Butt. This is characterized by excess sagging skin, volume loss in desirable curves, and a more aged appearance.
Impressions Face + Body’s Dr. Eric W. Anderson, a prominent figure in aesthetic plastic surgery, emphasizes the transformative impact of GLP-1s for medical weight loss. “GLP-1 medication has revolutionized American healthcare. About 40% of Americans are obese, and most of those patients also have high blood pressure, high cholesterol, and unstoppable food cravings. These medications act directly on hormonal pathways to decrease cravings and eliminate stubborn body fat; ultimately treating high blood pressure, high cholesterol, and diabetes. Not only are our patients looking great, but they also feel more energy and a renewed passion for life!”
In this article, we will explore the causes of loose skin, volume loss, and accelerated aging associated with GLP-1 medication, share expert insights from Dr. Anderson, and provide actionable solutions to help you maintain your facial aesthetics while enjoying the weight loss benefits of GLP-1 medication.
GLP-1 medications cause volume loss by dynamically reducing fat, including the fat in the face, arms, abdomen, hips/buttocks, and thighs. The volume provided by fat is important for maintaining a youthful look in some of these areas, such as the face and hips/buttocks.
“Fat cells are a well-known producer of estrogen, which is crucial for both men and women,” Dr. Anderson explains. "The estrogen produced by fat cells directly impacts the skin, improving its thickness, reducing wrinkles, and stimulating collagen production." A significant reduction in fat leads to less estrogen being available for the skin, resulting in a less youthful appearance, with the skin sagging and aging more rapidly.
Dr. Anderson’s colleague Dr. Steven Dayan, a facial plastic surgeon, recently presented at the IMCAS World Congress in Paris and authored an upcoming article for the Aesthetic Surgery Journal that supports this unique mechanism, which impacts adipose-derived stem cells in the upper layers of the dermis. “GLP-1 agonists, Ozempic in particular, turn off the adipose-derived stem cells within the skin, in the upper layers of the dermis,” Dr. Dayan elaborates. “By turning off those adipose-derived stem cells, you reduce the ability to stimulate fibroblast production, collagen formation, elastin, and other substances that make the skin look good. Adipose-derived stem cells are critically important to the skin's health, and if you turn those off, the skin ages faster.”
Patients using GLP-1 medications often experience rapid and noticeable changes in their body appearance due to fat loss. “Patients are noticing their clothes immediately fit better, but they are also noticing that their skin is not responding as fast as the fat,” Dr. Anderson explains. As weight is gained, the skin stretches to accommodate the excess volume. When volume is lost, the skin rebounds, but only to a certain extent.
“Patients are noticing excess skin on their upper arms, legs, breasts, and abdomen, and are seeking treatments to address this issue quickly,” Dr. Anderson says. “It’s not just about looking older; removing excess skin offers significant functional benefits. Clothes fit better, rashes in skin folds are prevented, and intimacy improves. Ultimately, patients feel better about themselves and want to reflect on their feelings.”
Arms: Loss of fat in the upper arms can lead to a significant amount of hanging skin. This impacts the ability to wear sleeveless garments in the summer or fit into jackets.
Breast: The fat reduction also applies to breast tissue, often leaving the breasts deflated and touching the abdomen, which is another sign of aging.
Abdomen: Abdominal skin has an innate ability to withstand lots of dynamic forces, as we carry most of our weight in our midsection. However, when the weight is lost, many patients are left with a hanging apron of skin or, in some cases, excess skin over the pubic area. This can lead to hygiene challenges and rashes in skin folds.
Hips/Buttocks: Losing volume in the hips and buttocks is detrimental for men and women alike! Fat reduction in the buttocks can create a flat hind section and lead to hanging skin, which can make fitting into pants difficult.
Thighs: As fat is reduced from the thighs, excess skin often appears on the inner surface. This can lead to hygiene issues near the groin, as well as a knobby appearance around the knees.
Loose Skin: Without the support of underlying fat, the skin can sag, giving the arms, breasts, abdomen, hips, and buttocks a more aged appearance. Additionally, excess skin is heavy and can trap moisture, leading to rashes in the folds.
Wrinkles: The loss of fat volume and reduced hormonal support for collagen can worsen the appearance of aging, making wrinkles more pronounced.
Deflated breasts: As we age, breast tissue is more affected by weight fluctuations. Over time, breast tissue is gradually replaced by fat, and the loss of fat can lead to a collapse of youthful volume. Treatment often involves removing excess skin and restoring volume.
Biostimulators: Biostimulators like Sculptra and Radiesse are popular non-surgical options for restoring lost volume, improving skin quality, and providing a lasting glow anywhere on the body. These treatments work by stimulating the body to enhance collagen and elastin production.
Dr. Anderson explains, "When treating 'Ozempic Body' in patients on GLP-1 agonist medications, the most effective approach is to stimulate the body’s natural bio-regenerative ability. However, biostimulators alone don’t always achieve the ideal result. Oftentimes, a combination of different treatments is needed to give patients the natural and holistic outcome they desire."
Skin Tightening Procedures: Skin tightening procedures like microneedling and radiofrequency (RF) are also beneficial for patients experiencing facial volume loss. These treatments work by stimulating collagen and elastin production, which are essential for maintaining firm and youthful-looking skin. Microneedling involves creating tiny punctures in the skin to trigger the body’s natural healing process, leading to increased collagen production. RF treatments use radiofrequency energy to heat the deeper layers of the skin, promoting collagen and elastin production without damaging the surface. Both methods can help reduce sagging and improve the overall texture and tightness of the skin.
Surgical Options
For more severe cases of “Ozempic Body,” surgical solutions can provide significant and lasting results. Below, Dr. Anderson breaks down various surgical options for patients:
Arm lift: Arm lift, also known as brachioplasty, is a common surgical solution for patients with significant fat loss. This procedure involves removing extra skin and tightening the overall arm contour, resulting in a more youthful and rejuvenated arm. Dr. Anderson explains, “The advanced technique I use combines contouring liposuction with removal of loose skin for the best result, and no drains are required!”
Breast lift: The best strategy to correct loose breast skin involves a combination of removing extra skin, lifting the nipple-areola complex, and re-arranging volume to yield a natural, rejuvenated result.
Tummy Tuck (Abdominoplasty): One of the key benefits of GLP-1 medications is the reduction of visceral fat—the fat inside the abdomen that cannot be surgically removed. As the abdominal circumference decreases, patients are often left with loose, hanging skin.
“A tummy tuck allows me to treat all three layers of the abdominal wall; I remove extra skin and fat and tighten the abdominal muscles,” Dr. Anderson elaborates. “This improves core strength and gives a patient that beautiful hourglass figure.”
Thigh lift: Inner thigh lift, also called thigh-plasty, is similar to the advanced technique used in the arm lift. Dr. Anderson combines contouring thigh liposuction and the removal of loose thigh skin to give a holistic natural result.
Fat Transfer: Another surgical option is fat transfer, which involves moving fat from other areas of the body to regions such as the breasts, hips, or buttocks. This procedure helps restore volume and improve skin quality by providing the necessary support to areas affected by fat loss, helping to maintain a youthful appearance. It’s a revolutionary technique for the right patient, with about 60% of the transferred fat surviving long-term. The results are beautifully natural and subtle, and the procedure can be repeated to enhance outcomes.
Dr. Anderson adds, “Fat grafting can be combined with skin tightening techniques for synergistic results. It’s always natural, always subtle, for that refined, youthful look.”
Combination Treatments: Dr. Anderson emphasizes a holistic treatment approach to yield the best results. “For the most satisfying results, a combination of treatments is often necessary. Using fat grafting along with bio-regenerative products or coupling a breast lift with fat transfer can provide a more natural and long-lasting outcome.”
Dr. Anderson stresses the importance of consulting with a qualified plastic surgeon. Choosing a professional with extensive experience ensures that the patient receives the most effective and safe treatment tailored to their specific needs.
“Any patient who's experienced volume loss and loose skin should seek a surgeon who is experienced and highly credentialed,” he explains. “Make sure your surgeon’s aesthetic matches your own.”
Maintaining skin health during weight loss is crucial to minimize the effects of facial volume loss and keep your skin looking vibrant. Here are Dr. Anderson’s tips:
Hydration: Staying hydrated is essential for maintaining skin elasticity and overall health. Drinking plenty of water helps to keep the skin plump and reduces the appearance of fine lines and wrinkles.
Nutrition: A balanced diet rich in vitamins and antioxidants supports skin health. Foods high in vitamins A, C, and E, as well as omega-3 fatty acids, can help nourish the skin from within. Incorporating plenty of fruits, vegetables, and healthy fats into your diet can help maintain your skin’s natural glow and elasticity.
Skincare Routines: Regular use of moisturizers and sunscreens helps protect and nourish the skin. A good skincare routine can include products that promote collagen production and skin renewal. Using products that contain ingredients like hyaluronic acid, retinoids, and peptides can help support your skin’s structure and appearance.
Exercise: Regular physical activity improves circulation and promotes healthier skin. Exercise also helps maintain muscle tone, which supports the skin and reduces the appearance of sagging. A combination of cardiovascular and strength-training exercises can be especially beneficial.
Dr. Anderson is an expert in breast surgery and body contouring, and he’s ready to discuss your goals with you. You’ve lost the weight—now let’s focus on addressing your areas of concern to help you achieve the best version of yourself! Whether you're considering surgical or non-surgical options, we encourage you to book a consultation with our team.