Combating “Ozempic Face”

Ozempic, a medication initially designed for managing type 2 diabetes, has become a groundbreaking tool for weight management. With its ability to significantly reduce weight, Ozempic has gained popularity among those looking to shed extra pounds. However, while its benefits for weight loss are widely celebrated, it brings an unexpected side effect that many have termed "Ozempic Face,” characterized by notable facial volume loss.

Impressions Face + Body’s Dr. Dayan, a prominent figure in the field of facial aesthetics, emphasizes the transformative impact of Ozempic. “The Ozempic craze has changed all of medicine, hell, all of the US, all of health. There's probably no bigger drug in the history of humanity in the last 30, 40, 50 years. This drug is completely changing the whole fabric of America,” he states. “You have 40% of Americans that are obese. If you look in Europe, it's around 20%... There are so many patients on this drug right now who are using it, and the results, frankly, have been quite fantastic. For weight loss, it's revolutionizing a lot of the way patients look. But not only that, the way they feel.” 

In this article, we will explore the causes of facial volume loss associated with Ozempic, share expert insights from Dr. Dayan, and provide actionable solutions to help you maintain your facial aesthetics while enjoying the weight loss benefits of Ozempic.

Understanding the Effects of Ozempic on Facial Aesthetics

Ozempic causes facial volume loss by reducing fat, including the fat in our face, which is significant for maintaining a youthful look. 

He further explains the role of facial fat, “When you're heavy, you have a lot of fat in your dermal fat cones, which are little fat pouches that go into the dermis, coming from the subcutaneous tissues. That fat reduces as you lose weight.” This reduction in fat contributes to a less youthful appearance, causing the skin to sag and wrinkle.

Dr. Dayan also points out that while losing weight typically leads to wrinkles due to reduced volume, Ozempic has a unique impact. “Ozempic is not working just by removing fat. It's not just losing volume in the face, and everything's just wrinkling down like a raisin. There's something unique going on, something idiosyncratic, something very specific to Ozempic.”

His recent theoretical research, presented at the IMCAS meeting in Paris and soon to be published in the Aesthetic Surgery Journal, supports this unique mechanism - it impacts adipose-derived stem cells in the upper layers of the dermis. “Ozempic in particular, or semaglutide type products, or GLP-1 agonists, turns 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 really critically important to the health of the skin, and if you turn those off, then the skin ages faster.”

Symptoms of Ozempic Face

Patients using Ozempic often experience noticeable changes in their facial appearance due to fat loss. Dr. Dayan explains, “Patients are noticing their faces becoming very thin and are seeking treatments to address this issue. It's not just about looking older; it's about the way they feel better about themselves and want to invest in their appearance.”

Commonly Affected Areas

Cheeks: Loss of fat in the cheeks can lead to a gaunt appearance, causing the cheeks to look hollow and less young.

Jawline: The reduction in facial fat may result in a less defined jawline, leading to a sagging or drooping appearance.

Around the Eyes: Volume loss around the eyes (periocular) can cause hollowing and the appearance of dark circles, making the eyes look sunken and tired.

Neck: Loose and hanging skin in the neck area is another frequent concern, often due to the loss of supportive fat.

While these are the most common affected areas, Dr. Dayan notes, “...that's not necessarily what the patients are coming in for. And this is really a unique aspect of the patients who are on these products. They're not so unhappy with the way their face looks. They've been heavy for a long time. They love the thinness they feel in their body, but they also tend to like the thinness they see in their face.”

However, there are specific areas which patients commonly request treatment for. “While they may have hollows in their cheeks and their temples and around their eyes, and I may say, let's treat these areas, they often come in saying, 'Doctor Dayan, my neck looks loose,' because they lose the fat in their neck. They see the loose and the hanging skin. So that's the area they most commonly request."

Aesthetic Issues Resulting from Fat Loss

Sagging Skin: Without the support of underlying fat, the skin can sag, giving the face a more aged appearance.

Wrinkles: The reduction in facial volume can exacerbate the appearance of facial aging and wrinkles, making them more pronounced.

Hollow Cheeks and Eyes: The loss of fat in the cheeks and around the eyes can create a hollow look, diminishing the youthful fullness of the face.

Treatment Options for Ozempic Face

Non-Surgical Treatments

Dermal Fillers: Dermal fillers are a popular non-surgical option for restoring lost volume in the face. These fillers, often composed of hyaluronic acid, can effectively fill in areas that have lost fat, such as the cheeks, temples, and under the eyes.

Dr. Dayan explains, “For treating Ozempic face in patients on GLP-1 agonist medications, the most effective approach is likely volume replacement, such as with fillers. However, fillers alone don't seem to achieve the expected results, unlike in patients not on these medications. This may be because fillers also stimulate adipose-derived stem cells, which are suppressed by Ozempic or GLP-1 agonists. Therefore, when using fillers, we likely need to supplement them with another bioregenerative product. I have some insights on this, and if you're interested, you can come in, and I'll share more details.”

Skin Tightening Procedures: Skin tightening procedures such as 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 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 Face, surgical solutions can provide significant and lasting results. Dr. Dayan discusses several surgical options:

Facelifts and Facial Augmentations: Facelifts are a common surgical solution for patients with significant facial volume loss. This procedure involves tightening the underlying tissues and removing excess skin, resulting in a more youthful and rejuvenated appearance. Dr. Dayan explains, “If they're looking for surgical solutions, I usually recommend a surgical facelift. I'll typically perform a deep plane facelift, focusing on tightening the lax skin in their neck. I use a deep neck approach to reduce submental fat and tighten the platysma muscle, which is the sling muscle around the neck. This approach is very common for my patients.”

Neck Lifts: Dr. Caughlin, another world renowned facial plastic surgeon and part owner of Impressions Face + Body has also seen an uptick in neck lifts in younger patients. “I've definitely started doing a few face and neck lifts in a younger population. I did one on a 33 year old woman. She lost 150 pounds. I mean, there just was no option.” 

Fat Transfer: Another surgical option is fat transfer, which involves transferring fat from other parts of the body to the face. This procedure helps restore volume and improve skin quality by providing the face with the necessary fat to support a youthful appearance. Dr. Dayan advises caution with this method, “I may also put a little fat in them, which is a little bit controversial. I'm cautious with it because if they are to gain weight in the future, you don't want their faces to get grotesquely distorted. So I put little bits of fat in certain areas of the face where I think they can benefit from it. 

Dr. Caughlin adds, “I mean, with a fat transfer sometimes they do two separated by six months. You can get a really nice soft outcome if you add a skin tightening component, whether it be a lift or a laser. I think it can be impressive.” 

Combination Treatments: Dr. Dayan emphasizes that combining treatments often yields the best results. “For the best results, a combination of treatments is often necessary. Using fillers along with bio regenerative products or coupling a facelift with fat transfer can provide a more natural and lasting result.”

Dr. Dayan stresses the importance of consulting with a qualified plastic surgeon or dermatologist. “Any patient who's experienced volume loss, who wants to see an aesthetic provider, should go to someone who's highly experienced and highly credentialed. There's no doubt the more experience someone has, the more likely you're going to get a better result.” 

Like anything in life, it goes without saying - choosing a professional with extensive experience ensures that the patient receives the most effective and safe treatment tailored to their specific needs.

Lifestyle Tips

Maintaining skin health during weight loss is crucial to minimize facial volume loss's effects and keep your skin looking vibrant. Here are some 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 can improve circulation and promote healthier skin. Exercise also helps in maintaining muscle tone, which can support the skin and reduce the appearance of sagging. Incorporating both cardiovascular and strength-training exercises can be beneficial.

Book A Ozempic Face Treatment Consultation With Impressions Face + Body

Dr. Dayan and Dr. Caughlin are two of the top facial plastic surgeons in the world - and they are ready to talk with you about your goals. You’ve shed the weight, now let’s address your areas of concern for the best version of yourself! Whether you’re interested in surgical or non-surgical solutions, we encourage you to book a consultation with our team.