The treatments sought after weight loss include injectable dermal fills to help restore facial volume, facial lifting and fat transfers. But sometimes it is not enough and “surgical intervention” is necessary “
The “Ozepic face” may be boosting a boom in aesthetic surgery
by Oscar HollandCNN
About two years ago, the famous cosmetic dermatologist Paul Jarrod Frank noticed a new type of patient to reach his office in New York. In the midst of an explosion in the number of Americans to lose weight with medications such as Ozepic, Paul Jarrod Frank observed a “dramatic increase” in the number of clients with undesirable side effects.
“Although they felt much better because they lost weight, they felt like they looked older,” he said through a voice note. “And that was due to the loss of volume on the face.”
Paul Jarrod Frank began to use the term “Ozempic face” – a label he believes he was coined – to describe the phenomenon. Since then, it has become a common expression on social networks to describe skin sagging and the encouraged appearance that can follow the use of GLP-1 medications, such as semaglutado (the active ingredient in brand medicines such as Ozepic and Wegovy).
“Normally, in people in their early 40s or older, when you start losing more than 4.5 kg, you can have this kind of look,” says Paul Jarrod Frank, founder of the Pfrankmd Aesthetic Health Care brand and author of the book “The Pro-Agg Playbook”. “Certainly, people who lose more than 9 kg or 13 kg will have this problem.”
SEMAGLUTIDO acts by stimulating the pancreas to produce insulin, reducing the appetite of people who consume it and contribute to the feeling of satiety. Although US Food and Drug Administration (FDA) has approved Ozempic for treating type 2 diabetes, doctors now prescribe it off-label for weight control. About one in eight adults in the US has already used a GLP-1 drug and, about two out of five out of five, they did so exclusively to lose weight, according to the non-profit organization KFF, specializing in health policies in 2024.
Today, more than 20% of Paul Jarrod Frank patients are using LPG-1 as part of what “regime of longevity” is called. The treatments sought after weight loss include injectable dermal fills to help restore facial volume, facial lifting and fat transfers.
“It is only possible to fill an empty balloon to some extent and a surgical intervention is often necessary,” says Paul Jarrod Frank. But for many patients, he adds, “just increase the dosage of volume replacement.”
“Someone who may have used a past -filled syringe 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 surgery trends, recently found that two out of five GLP-1 patients were considering undergoing cosmetic surgery-and one in five had already done so.
Patients who opted for facial lifting was Kimberly Bongiorno, a local land use administrator of Mount Arlington, Nova Jersey. Having lost weight after gastric sleeve surgery in 2019, he recovered 18 kg during the Covid-19 pandemic and received a Wegovy prescription 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.
“It was a little hanging and very flabby,” he says in an interview with CNN for Zoom, remembering to have seen his face in a photo shared by a friend. “I no longer felt that I had cheeks and had a lot of flabby skin under my neck. It looked like I had melted. It was horrible,” he adds. “It was so discouraging to see how my face was and how it had changed, I thought it looked much older than I am.”
After consulting the plastic surgeon Anthony Berlet at a New Jersey office, Bongiorno did a deep facial lifting that raised the skin and repositioned some of the deepest muscles and connective tissues. It also opted for a neck lifting that refined and softened the contours of the neck, while dealing with excess skin left by weight loss.
“Before doing this, it probably seemed to be closer to 60 – or maybe even more. And now I have people who have recently met who think I’m in the 40s,” says Bongiorno. “People I hadn’t seen for a while say, ‘They look so healthy and happy.’ And it’s good to hear that, because for a while it didn’t seem healthy and it was certainly not happy.”
The number of facial plastic surgeries performed in the US increased by 8% between 2022 and 2023, according to ASPs data. The use of hyaluronic acid fills, in turn, doubled from 2.6 million Americans in 2017 – the year Ozepic was first approved for diabetes – to over 5.2 million by 2023.
The organization could not assign these increases exclusively to the use of LPG-1, but its former president Steven Williams says drugs had “a global effect on cosmetic surgery.”
“Now we have a totally new tool that really is effective for many patients,” says Williams, a certified plastic surgeon and founder of Tri Valley Plastic Surgery, California, in CNN statements also by Zoom. Steven Williams says the LPG-1 come “without substantial disadvantages” when 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 adds. “And as part of this conversation, there is an obligation to say ‘look, this will really work, so you have to be prepared for what will be 20 or 50 pounds less.”
The term “ozempic face” may be typical of our times, but its symptoms – caused by a decrease in subcutaneous fat that makes our faces fuller – not new. Plastic surgeons have long been dealing with 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.
In adulthood, “the body no longer produces adipose cells,” explains Williams. “As we lose or gain weight, these adipose cells do not multiply or decrease; they get larger or smaller. And so, as we lose weight, these adipose cells decrease in volume and less filling.”
Preventive measures
Age can determine how the patient’s face reacts to weight loss. People in their 20s and 30 years, for example, are much less likely to show signs of aging due to the use of LPG-1, says Frank.
“As they have good skin elasticity, the skin recovers much better.”
Patients aged 20 to 39 accounted for 14% of the use of Hyaluronic acid filling in the US and only 2% of facial lifting procedures last year, according to ASPs. But both numbers are increasing.
Gabriela Vasquez, 29, is among younger patients using LPG-1 to undergo cosmetic procedures after rapid weight loss. Employee at one of the clinics Triley Plastic Surgery from Williams has lost about 23 kg since he started taking Ozepic in November.
Although Vasquez is still working to achieve his ideal weight, he has sought out of preventive Botox injections (more visible lines and wrinkles, along with thinner lips, are among the other side effects of the use of LPG-1). It also recently underwent a micro -aging procedure used to stimulate collagen production.
“One of my concerns was my chin, because I felt it was more protruding when I was a little heavier,” he tells CNN in an interview also by Zoom. “I think the micro -gadget definitely helped. I never had a jaw contour. And a few weeks ago, someone took a picture of me and I had a contour and thought ‘well, this is new.'”
Vasquez did not rule out the possibility of performing more cosmetic procedures as he continues to lose weight – not just on his face and neck. “I’m seeing little things in my body that make me think ‘wow, it would be good to treat it,” he says, referring to excess skin under his arms. “I can imagine myself-later, when I reach my ideal weight-doing something to tighten everything.”
Frank, the cosmetic dermatologist, notes that the “Ozepic face” can be accompanied by a phenomenon that nicknames “Ozepic Body”, adding: “One of the other important side effects of weight loss, especially when at a rate of over one to two pounds a week, is muscle loss. And we see it all over the body.”
ASPs similarly observe the emerging term “Ozempic transformation”, a set of procedures that can also include abdominoplasties, mastopexias and lifting of arms, thighs and buttocks.
For example, Bongiorno, the New Jersean facial lifting patient, has also undergone several other procedures with Berlet, including arms and thighs, to treat excess skin. Bongiorno estimates that after the next breast lifting, fat graft and lower eyelid surgery, he spent about $ 70,000 on cosmetic procedures.
“The skin is heavy and uncomfortable,” he said. “It wasn’t something I did to go around and be a supermodel. It was just to feel comfortable, so I could wear clothes and not feel that I was carrying 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 can reduce the demand for liposuction, for example, has not materialized: it remains the most common aesthetic surgical procedure in the US, with an increase of 1% popularity last year, according to ASPs data.
What is still to be seen is the effect that the “Ozepic relapse” – when patients recover weight after interrupting the use of medicines – has about people who sought cosmetic procedures.
A recent study found that most people who use weight loss drugs give up within a year. Data presented at this year’s European Obesity Congress suggested that patients normally returned to their original weight within 10 months after interrupting use, with Oxford University researchers to ask for a “caution grade” about drug use “without a broader approach” for weight loss.
For Williams, this demonstrates even more why he and fellow plastic surgeons should take responsibility for the entire “journey” of his patients, not just the cosmetic procedures.
“We don’t want these patients to take these medicines for a lifetime. We want to be a temporary bridge for a healthier lifestyle. It is our obligation to work more with these patients, talk about lifestyle changes, refer them to nutritionists and ensure that they are building muscles and exercising.”
