How plastic surgery can address "Ozempic face"

Many people are accelerating their weight loss journeys after recent breakthroughs. These medications, such as Ozempic, Zepbound and many others, are helping patients shed stubborn fat, maintain healthier lifestyles and finally achieve the bodies they've always wanted.

But one side effect is getting a lot of attention – the so-called "Ozempic face." It's a hot topic among doctors and patients because it's a result of rapid weight loss.

So, what exactly is Ozempic face, and how can it be treated? Which treatments are most effective? We spoke with ASPS Member Surgeons Michelle Lee, MD, and Daniel Beck, MD, to get their thoughts around this weight loss side effect and the best ways to counter it.

Root causes of Ozempic face

This term is closely tied to one of the most popular weight loss drugs, but it actually applies to any semaglutide medication.

"Ozempic Face is the not-so-glamorous nickname for what happens when rapid weight loss leaves the face looking hollow, saggy or prematurely aged," said Dr. Beck. "When your body sheds pounds fast, especially with GLP-1 medications like Ozempic or Mounjaro, it doesn't just lose fat from the waistline. It can strip essential volume and muscle tone from the face, leaving patients with sunken cheeks, hollow eyes, loose skin and an overall tired and worn-out appearance."

Losing weight has obvious health benefits, but it can also cause the loss of facial fat, which can make you look older.

"What we refer to as Ozempic face is a noticeably gaunt or hollowed facial appearance," said Dr. Lee. "This is a hallmark side effect associated with dramatic weight loss from medications like Ozempic. Rapid weight loss coincides with a rapid loss in facial volume, which in turn leads to skin laxity. Facial volume loss prematurely ages the face, especially if the skin is unable to retract as quickly as the volume loss. This combination of volume depletion and skin laxity results in a more aged appearance, with wrinkles and hollow areas becoming more pronounced.

"For example, when the fat pads in the face, particularly in the cheeks and temples, shrink too quickly, the skin may not retract at the same pace, resulting in a deflated or loose appearance," continued Dr. Lee. "Second, a notable change in skin quality occurs after the use of Ozempic. While further research is needed to fully understand how GLP-1 medications like Ozempic impact collagen and elastin, anecdotal evidence suggests that the skin loses its elasticity and feels more doughy."

The popularity of these drugs means this side effect happens frequently.

"Loss of volume in the face is more common than people realize," said Dr. Beck. "With significant weight loss, fat in the face shrinks just like fat in the rest of the body. The big difference, which is likely causing the awareness of Ozempic face, is how quickly the weight loss and changes to the body occur. With gradual weight loss, people often notice the changes in other areas of their body first – pants fit better, shirts are not as tight. In fact, they may not even appreciate the changes in the face until someone else comments on it, as loss of facial fat volume may first appear as a slimming and toning of the face."

So, is Ozempic face an inevitability when taking these weight loss drugs?

"It varies depending on the patient's age and the rate of weight loss," said Dr. Lee. "Younger patients typically have more skin elasticity, so their skin is more likely to retract naturally. However, when weight is lost quickly, especially in older patients or those with reduced collagen production, facial sagging and hollowing are more likely to occur. But if the weight loss happens gradually, and the skin is given a chance to retract in tandem with the volume loss, we don't typically see this."

There are treatments available to counteract Ozempic face, but your best bet is to try to prevent it.

"Gradual weight loss is key," said Dr. Lee. "Ideally, weight loss should be limited to one to two pounds per week, giving your body the chance to adapt to these changes. In addition, maintaining a healthy baseline of hydration and a protein-rich diet further supports skin health."

Surgical and nonsurgical interventions for Ozempic face

There are plenty of options to address this side effect because it is so common among people who use weight loss drugs.

"When looking to counter the effects of Ozempic face, we must treat all the areas affected by rapid weight loss," said Dr. Beck. "This includes the loss of volume, but also loss of muscle and structural support, plus changes to the skin tone and quality."

Surgery may not be necessary to treat Ozempic face because several nonsurgical options are also available to patients.

"In terms of treatments, we focus on collagen-stimulating procedures such as Sofwave, microneedling and biostimulatory injectables like Sculptra, which enhance skin quality and elasticity," said Dr. Lee. "For patients with noticeable volume loss, dermal fillers or fat transfer are often used to counteract Ozempic face."

However, surgery often gives the best results, especially in dramatic cases of Ozempic face.

"The most effective and popular and effective surgical method is a facelift with fat grafting and skin resurfacing," said Dr. Lee. "A facelift repositions and tightens sagging tissues, while fat grafting replenishes volume in areas with a hollowed appearance. Laser resurfacing perfectly complements a facelift with fat grafting, further improving skin quality, texture and tone."

Dr. Beck offered a detailed breakdown of what procedures may be an option for patients experiencing Ozempic face:

• Fat grafting: Volume loss is restored using your own fat, transferred with precision to areas like the cheeks, temples or under eyes. This provides a natural, permanent alternative to fillers.
• Facelift: The deeper layers of face tissue are lifted and repositioned to restore structure and eliminate excess sagging, depending on the severity of the facial aging. This is especially effective for men, where strong, defined contours are a key element of facial structure.
• Blepharoplasty: Eyelid surgery can remove excess skin and tighten supporting muscles around the upper and lower lids for those who have experienced volume loss and hollowing around the eyes.
• Neck lift: Often overlooked, the neck is one of the first areas to reveal signs of major weight loss. A neck lift addresses loose skin and poor contour, tightening everything from the jawline to the collarbone.
• Lip lift: In some cases, dramatic fat loss can cause the upper lip to elongate or lose its youthful shape. A lip lift restores upper lip shape, accentuates volume and gives balance and back to the lower third of the face.

Determining the right path forward for patients

Both experts agree that being proactive with prevention is critical for those at risk of Ozempic face.

"Encourage patients to pursue slow, sustainable weight loss while proactively supporting their skin with collagen-stimulating treatments can help avoid premature facial aging and the need for young facelifts," said Dr. Lee.

Additionally, consider including some additional nutrients in your diet.

"Incorporating targeted supplements like CLA, ALA and HMB into your weight loss journey supports the preservation of facial tissue, muscle tone and overall skin health during weight loss," said Dr. Beck. "Splitting weekly dosing of GLP-1 medications may prove to lessen known side effects such as nausea and fatigue, allowing you to maintain a more active lifestyle and maintain muscle mass."

If you still see changes despite taking preventative measures, your board-certified plastic surgeon will work with you to create a personalized plan to reach your aesthetic goals.

"For those already experiencing changes, the treatment plan is highly individualized, largely based on key factors like age, skin quality, the specific degree of volume loss and personal aesthetic goals," said Dr. Lee. "Often, a combination of nonsurgical and surgical techniques is most effective."

The intent is to restore and rebalance your face using a variety of options.

"My philosophy is that we are not here to give you a new face," said Dr. Beck. "We're here to bring back the best version of the one you lost, with strength, symmetry and structure. This all starts with a thorough consultation for a facial assessment. I look at the quality of the skin, volume loss, muscle tone and then discuss the patient's goals."

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.