About two years ago, celebrity dermatologist Dr. Paul Jarrod Frank noticed a new type of patient coming to his clinic in New York. Amid the explosion in the number of Americans losing weight with medications such as Ozepic, he saw a “dramatic increase” of customers experiencing unwanted side effects.
“Although they felt much better losing weight, they somehow felt they looked older, and this was due to the loss of volume on their face,” he said.
Frank started using the term “Ozepic Face” – A label he believes to have coined – to describe the phenomenon. Since then, it has become a jargon on social networks for flabby skin and A, such as Semaglutida (the active ingredient in brand medicines such as Ozempic and Wegovy).
“Generally, in people from the early 40s, when you start losing more than 4.5 kg, you can have this kind of uninflated look,” said Frank, founder of the aesthetic health brand Pfrankmd and author of “The Pro-Agg Playbook”. “Certainly, people who lose more than 9 or 13.5 kg will have this problem.”
SEMAGLUTIDO works by stimulating the pancreas to trigger insulin production, controlling users’ appetite and contributing to the feeling of satiety. Although US Food and Drug Administration (FDA) has approved Ozepic to treat type 2 diabetes, doctors now prescribe it commonly for weight control outside the original indication.
About 1 in 8 adults in the US used a GLP-1 drug and, of these, about 2 out of 5 did so only to lose weight, according to the non-profit KFF health policy organization in 2024.
Today, more than 20% of Frank patients are using LPG-1s as part of what he called his “longevity regime.” Treatments sought after weight loss include injectable dermal fills to help restore facial volume, facelifts and fat grafts.
“You can only replenish a uninflated balloon to some extent, and often surgical intervention is necessary,” he said. But for many patients, he added, “just increasing the dosage of their volume replacement is more than enough.”
“Someone who may have used a fill syringe in the past is now using two or three.”
“It looked like I had melted”
The American Society of Plastic Surgeons (ASPs), which publishes an annual report on surgical trends, recently found that 2 out of 5 patients in their members who use GLP-1 were considering aesthetic surgery – And 1 in 5 had already done.
Among the patients who opted for a facelift was Kimberly Bongiorno, an administrator of land use of local government of Mount Arlington, New Jersey. Having lost weight after vertical gastrectomy surgery in 2019, she recovered 18 kg during Covid-19 pandemic and was prescribed from Wegovy last year. Despite describing the impact of the drug as “almost a miracle” – taking its weight from 77 kg to 57 kg – the 55 -year -old woman faced new concerns about her appearance.
“Everything simply hung and was very loose,” she said by Zoom, remembering to see her face in a photo shared by a friend. “I no longer felt that I had cheeks, and I had a lot of loose skin under my neck.”
“It looked like I had melted. It was horrible,” he added. “It was so discouraging to see how my face looked and how I had changed, I thought it looked much older than I am.”
After consulting the plastic surgeon Dr. Anthony Berlet at his office in New Jersey, Bongiorno underwent a Deep Plane Facelift that raised his skin and repositioned some of the deepest muscles and connective tissues. She also opted for a Neck Lift who refined and softened the contours of her neck, addressing excess skin left by weight loss.
“Before I did that, I probably looked closer to 60, or maybe even older. And now I have people who have recently met who think I am 40 -one years old,” said Bongiorno, adding, “People I haven’t seen for a while say,” You look so healthy and happy. “
O Number of Facelifts held in the USA increased by 8% between 2022 and 2023according to ASPs data. The use of Hyaluronic acid fills, in turn, doubled from 2.6 million Americans in 2017 – year when Ozepic was first approved for diabetes – to more than 5.2 million in 2023.
The organization could not assign these increases exclusively to the use of LPG-1, but its former president, Dr. Steven Williams, said the medicines had “a global effect on cosmetic surgery.”
“Now we have a brand new tool that really is effective for so many patients,” said Williams, a certified plastic surgeon and founding of Tri Valley Plastic Surgery from California by Zoom. He noted that the LPG-1s come “without substantial disadvantages” compared to invasive procedures such as gastric bypass surgery.
“Now we can have an honest conversation with patients about a non -surgical tool that is effective in weight loss,” he added. “And as part of this conversation, there is an obligation to say, ‘Look, it will really work, so you have to be prepared for what will look like 9 or 23 kg thin.’
The term “Ozempic’s face” may reflect our times, but its symptoms – caused by a decrease in subcutaneous fat that makes our faces fuller – it’s not new. Cosmetic surgeons have long treated the side effects of significant weight loss. In fact, a popular mark of dermal filling, Sculptra, was originally developed in the 1990s for HIV patients.
As an adult, “your body actually produces fat cells anymore,” said Williams. “As we lose or gain weight, these fat cells are not multiplying or decreasing; they are getting larger or smaller. And so, as we lose weight, these fat cells now have decreased volume, and there is only less filling.”
Preventive measures
Age can determine how patient faces react to weight loss. People in their 20s and 30 years, for example, are much less likely to experience the appearance of aging due to the use of LPG-1, Frank said.
“Because they have good skin elasticity, the skin recovers much better,” he said.
Patients aged 20 to 39 represented 14% of the use of hyaluronic acid filling in the US and only 2% of facelift procedures last year, according to ASPs. But Both numbers are on the rise.
Gabriela Vasquez, 29, is among younger patients using LPG-1 to undergo cosmetic procedures after rapid weight loss. A employee of one of the clinics Tri Valley Plastic Surgery from Williams, she has lost about 23 kg since she started using Ozepic in November.
Although Vasquez is still working to reach her target weight, she has sought preventive Botox injections (more visible lines and wrinkles are, along with thin lips, among the other side effects of the use of LPG-1). It has also been recently subjected to microagulating, a procedure used to stimulate collagen production.
“One of my concerns was the double chin because I felt I saw her when she was a little heavier,” she said by Bay Area Zoom. “I think the micro -aging has definitely helped.”
“I never had a jaw line,” he added. “And a few weeks ago, someone took a picture of me, and I had one, and I thought, ‘Well, that’s new.’
Vasquez did not rule out other cosmetic procedures as he continues to lose weight – not just on his face and neck. “I’m seeing little things in my body I think, ‘wow, it would be good to take care of it,” she said, referring to the appearance of excess skin under her arms. “I see myself – later, when I reach my ideal weight – doing something to tighten everything.”
Frank, the cosmetic dermatologist, noted that the “Ozepic face” can be accompanied by a phenomenon that he dubbed “Ozepic Body”adding: “One of the other main side effects of weight loss, particularly when done at a rate of more than 0.5 to 1 kg per week, is muscle loss. And we see it throughout the body.”
ASPs observes similarly the emerging term “Ozepic Reform”a set of procedures that may also include abdominoplasties, breast lifting and lifting arms, thighs and buttocks.
For example, Bongiorno, the New Jersey Facelift patient, was also undergoing several other procedures with Dr. Berlet, including arms and thighs lifting to treat their excess skin. She estimates that after her next breast survey, fat graft and lower eyelid surgery, she will have spent about $ 80,000 on cosmetic procedures.
“The skin is heavy and uncomfortable,” she said. “This was not something I did to go out and be a supermodel. It was just to be comfortable, to be able to wear clothes and not feel that I was dragging all this extra weight.”
Open Questions
The long-term effect of GLP-1 medicines on aesthetic medicine is not yet fully understood. The assumption that they could reduce the demand for liposuction, for example, did not materialize: it remains the most common aesthetic surgical procedure in the US, growing in popularity by 1% last year, according to ASPs data.
What also remains to be seen is the effect that the “” – When patients recover weight after stopping drugs – there are about people who sought cosmetic procedures.
A recent peer -reviewed study found that most people who use weight loss drugs interrupt them in a year. Data presented at this year’s European Obesity Congress, in turn, suggested that patients usually return to their original weight in 10 months after the interruption of use, with researchers from the University of Oxford calling the “warning grade” discoveries about the use of medication “without a more comprehensive approach” for weight loss.
For Williams, this shows even more why he and his fellow plastic surgeons should take responsibility for the “entire journey” of his patients, not just for his cosmetic procedures.
“We don’t want these patients to use these drugs for a lifetime. We want it to be a temporary bridge for a healthier lifestyle,” he said, adding: “It is our obligation to work more with these patients, talk about lifestyle changes, connect them to nutritionists and ensure that they are building muscles and exercising.”
