‘Ozempic Face’: Fat Transfers, Fillers, and More

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June 13, 2024 – Since starting Zepbound – a GLP-1 weight loss medication – in January, Renata D’Agrella Kenen, 27, has dropped 30 pounds. As with many users of these drugs, Kenen’s rapid weight loss has given her a new sense of freedom from what she called the “chronic food noise” that made it difficult to focus on other things and added to obesity and other related health issues. 

“It has been the most transformative experience of my life,” she said. “This medication has tremendously improved my relationship with food, and I feel like I finally have control over my cravings and appetite for the first time in my life.”

Her overall health is improving, including her blood sugar levels.

“I feel in control of my health for the first time in my life,” she said.

But then Kenen heard of “Ozempic face” and grew concerned she may experience it. The cultural term for facial aging – like sagging skin and a gaunt appearance – can happen through quick weight loss from semaglutide (the generic name for Ozempic) or another GLP-1 medication like tirzepatide, the generic name of Zepbound.

Konstantin Vasyukevich, MD, a double board-certified facial plastic and reconstructive surgeon based in New York City, said almost every other new patient at his clinic is on Ozempic, and procedures to reduce or reverse Ozempic face have skyrocketed. 

Facial aging largely boils down to how quickly someone sheds pounds, according to David Hill, MD, CEO of Fulcrum Aesthetics, a Chicago-based plastic surgery and medical aesthetics clinic. 

“Probably 1 in 5 [people] see some difference in their facial aesthetics if they're on Ozempic and losing fat rapidly,” he said. 

Speedy weight loss from GLP-1 medications can reduce your facial volume, which can lead to wrinkles and sagging. There are surgical and nonsurgical treatments for Ozempic face. 

“We can restore the facial volume to its previous form (or somewhat close to it), or we can reduce facial laxity [loose skin],” said Vasyukevich. The former can be done through facial fat grafting, which is surgery that uses fat from another area of your body in your face to boost its volume. 

But there are critical things to keep in mind with fat grafting. With any type of liposuction, there is a chance you'll get "contour irregularity," or a lumpy appearance, Hill said. Another note: Fat cells (taken out of one area of your body and transferred to your face) are going to react to weight gain the same way. For example, if you typically gain weight in your stomach and it’s the same area doctors suctioned the fat.

“If people gain 50 pounds, they'll see that their face gains a lot of weight, too, because those fat cells are all going to get bigger,” Hill explained. “So, the main precaution for any fat grafting procedure is if the patient is very young or potentially going to become pregnant, or have any massive weight change, the fat that we transfer will also change in size and volume.”

For patients who prefer a thinner face but want to nix loose skin, a face or neck lift would be a good option, said Vasyukevich. Temporary fillers are a less invasive way to boost your facial volume. Laser resurfacing is another option.

“You are causing fractionated laser damage to the skin, which your body then heals by contracting,” Hill said. “It also has heat, which causes some skin contraction. So, you're fighting the effects of the weight loss and rapid skin deflation.”

Kenen said she prefers at-home preventive measures, such as using a gua sha (a tool that gently scrapes your skin to lessen inflammation and improve blood flow), but would be open to nonsurgical procedures like laser treatments and facials. If she ever happens to have sagginess, or a significant reduction in facial volume, a face lift or skin removal would be a last resort, namely if changes to her face were compromising her mental health.

“I am on my GLP-1 medication because I was experiencing health issues due to obesity – not because of how I looked,” Kenen said. “I would have a hard time doing an extreme medical procedure for aesthetics.”