Two years ago, Dr. Paul Jarrod Frank, a prominent cosmetic dermatologist based in New York, began to notice a shift in his patient demographics. With the rise of weight-loss medications like Ozempic sweeping across the United States, Frank observed an increase in clients facing unexpected side effects. “Although they felt much better losing weight, in some ways they felt they looked older,” he explained. “And this was due to the loss of volume in their face.”
To encapsulate this phenomenon, he coined the term “Ozempic face,” which describes the sagging skin and hollowed appearance that often follow the use of GLP-1 medications, including semaglutide, the active ingredient in Ozempic and Wegovy.
Frank noted that weight loss, particularly in individuals over 40 who lose more than 10 pounds, can transform their facial appearance. “Usually, with people from their mid-40s and above, once you start losing 10-plus pounds, you can get this kind of deflated look,” he remarked. He highlighted that surgical intervention is frequently necessary to correct this aesthetic issue.
Semaglutide’s primary function is to stimulate insulin production while suppressing appetite, contributing to feelings of fullness. Approved by the US Food and Drug Administration for treating type 2 diabetes, it is now commonly prescribed off-label for weight loss. According to KFF, a health policy non-profit, approximately 1 in 8 adults in the U.S. have tried a GLP-1 medication, with around 40% doing so solely for weight management.
Currently, more than 20% of Frank’s patients are utilizing GLP-1s as part of a “longevity regimen,” often seeking cosmetic treatments such as injectable dermal fillers to restore lost volume, facelifts, and fat transfers. “You can only refill a deflated balloon so much, and often surgical intervention is necessary,” he stated. Still, some patients find that adjusting their filler treatments suffices. “Someone who may have used one syringe of filler in the past is now using two or three.”
Insights from the American Society of Plastic Surgeons (ASPS) reveal a growing trend, with 40% of their members’ GLP-1 patients contemplating cosmetic surgery and 20% having already undergone procedures. Kimberly Bongiorno, a land use administrator from Mount Arlington, New Jersey, exemplifies this trend. After undergoing gastric sleeve surgery in 2019, she regained weight during the pandemic and was prescribed Wegovy last year. Although she hailed the drug’s effectiveness in reducing her weight from 170 to 125 pounds, she became increasingly self-conscious about her appearance.
“Everything just kind of hung and was very loose,” Bongiorno recalled, noting her distress upon seeing a photo that revealed how her face had changed. “It looked like I had melted. It was horrifying.” Following consultations with Dr. Anthony Berlet, she underwent a deep plane facelift and neck lift, procedures that have since revitalized her appearance. “Before I did this, I probably looked closer to 60, or maybe even older. And now I have people who I’ve recently met think I am in my 40s,” she shared, expressing gratitude for the compliments she now receives.
Data from the ASPS indicates an 8% increase in the number of facelifts performed between 2022 and 2023, alongside a doubling in the use of hyaluronic acid fillers since 2017. Although ASPS could not directly link these rises to GLP-1 usage, former president Dr. Steven Williams affirmed that these medications have had a profound impact on aesthetic surgery.
“Now we have a brand-new tool that actually has efficacy for so many patients,” he said, emphasizing the need for open discussions about the realities of weight loss and its effects on appearance. While the phrase “Ozempic face” encapsulates current concerns, the underlying causes of facial volume loss are not new; cosmetic surgeons have long dealt with the aftermath of significant weight loss.
Age plays a crucial role in how weight loss affects appearance. Younger patients in their 20s and 30s typically experience less visible aging effects from using GLP-1 medications, as they often enjoy better skin elasticity. That said, patients aged 20 to 39 accounted for 14% of hyaluronic acid filler use in 2022, a figure that is steadily increasing.
Gabriela Vasquez, a 29-year-old employee at Tri Valley Plastic Surgery, represents a younger demographic using GLP-1 for weight loss and cosmetic enhancements. Since starting Ozempic, she has lost about 50 pounds and sought preventative Botox and microneedling to combat visible signs of aging. “I think the microneedling definitely helped,” she remarked, sharing her surprise at noticing the emergence of a defined jawline.
As she continues her weight loss journey, Vasquez remains open to additional cosmetic work. “I could see myself — later down the line, once I get to my goal weight — doing something to kind of tighten everything up,” she expressed. Frank warned that “Ozempic face” could lead to a related issue he terms “Ozempic body,” noting muscle loss as another consequence of rapid weight reduction.
The ASPS notes the increasing prevalence of “Ozempic makeovers,” which may include procedures like tummy tucks and breast lifts. Bongiorno, for instance, has invested approximately $80,000 on various cosmetic enhancements to address issues stemming from her weight loss. “This wasn’t something I did to go out there and be a supermodel. It was just to be comfortable, so I could get clothes on and not feel like I was dragging around all this extra weight,” she said.
Looking ahead, the long-term impact of GLP-1 medications on cosmetic practices remains uncertain. While there were expectations that these drugs might diminish the demand for liposuction, its popularity continues to rise. Additionally, the phenomenon of “Ozempic rebound,” where patients regain weight after discontinuation, raises concerns for those who have undergone cosmetic procedures. Studies show many individuals using these drugs for weight loss tend to stop within a year, often regaining lost weight shortly after.
Dr. Williams underscores the importance of holistic patient care, urging colleagues to engage in discussions about healthy lifestyle changes in conjunction with cosmetic procedures. “We don’t want these patients to be on these medications for a lifetime. We want it to be a temporary bridge to a healthier lifestyle,” he concluded.
