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With the surging popularity of GLP-1 medications such as Semaglutide aka Ozempic for weight loss, comes an epidemic of individuals experiencing accelerated facial ageing from rapid weight loss. Characterised by a gaunt, sunken and saggy appearance, the term “Ozempic Face” was first coined by New York City Cosmetic Dermatologist Dr Paul Jarrod Frank. In a 2023 Business Insider interview, Dr Frank shared "I think a combination of age and the rapidity of the weight loss is what's causing what I call “Ozempic face”.When you meet someone that you saw not too long ago and they've lost a lot of weight, it's kind of like a telltale sign."
Just as the stories of Ozempic-aided weight loss took over social media came the horrifying images of Hollywood celebrities who had “gone too far” and were looking skinny and haggard after excessive weight loss.
“Ozempic Face” refers to the excessively skinny, gaunt and aged look seen in individuals who have recently underwent rapid weight loss. This is characterised by a hollow and sunken appearance on the cheeks and temples as well as accelerated signs of ageing such as loose skin and wrinkles. The nasolabial folds (laugh lines), marionette lines and jowls may appear deeper, and sagging skin around the jawline and neck becomes more prominent.
To understand Ozempic Face, one must first understand the natural facial ageing process- the face contains multiple pockets of fat known as ‘fat pads’ that support the skin of the face. When we are young, these fat pads are full, providing support and cushioning to give the face a youthful appearance. With the natural ageing process, the fat pads of the face shrink gradually, resulting in hollowness and sagging of the face.
Like fat elsewhere in the body, the fat pads on the face act as an energy source that the body may utilise. During rapid weight loss, the individual loses facial fat and collagen, accelerating the ageing process. “Ozempic Face” need not be due to the use of the medication Ozempic, it can also be seen in patients who have undergone bariatric (weight loss) surgery, are on excessively restrictive diets or have lost a significant amount of weight due to medical reasons (e.g. on chemotherapy).
While this is a relatively new phenomenon, several risk factors have been identified for the development of Ozempic Face. Firstly, the amount of weight loss matters- individuals who experience significant weight loss as defined by over 10% of body weight (ie >10kg in a 100kg person) are more likely to develop Ozempic Face. Secondly, the rapidity of weight loss matters- individuals who lose too much too fast (ie rapid weight loss in <6 month period) are more likely to develop Ozempic Face as their facial fat has reduced in size rapidly without giving their skin enough time to “catch up”. Lastly, the age of the individual matters, those in their 40s and 50s who already have significant collagen loss in their skin are more likely to develop Ozempic Face when they lose weight, as their skin no longer has the elasticity to “bounce back”
While this is a relatively new phenomenon, To reduce the risk of developing Ozempic Face, patients at Bay Aesthetics Clinic and Medispa undergoing medical weight loss treatment are closely supervised by their doctors. They are advised not to lose too much weight on the face, targeting a gradual weight loss of 1 kg per month over a period of 6-12 months. Medication dosage is carefully titrated to achieve gradual and constant weight loss, avoiding sudden and drastic changes.
Clients above 40 years old are recommended to undergo Collagen Banking to take proactive steps to build up their skin’s collagen reserves in anticipation of future collagen loss.
Over the past 2-3 years, Plastic surgeons have reported an uptick in patients seeking facelift surgery after rapid weight loss due to Ozempic use. Facelift surgery together with facial fat grafting directly addresses signs of facial ageing such as loose skin and facial volume loss, with significant results often possible. However, surgery comes with high cost, surgical risk and downtime.
For patients seeking rejuvenation without downtime, non-surgical treatment options include fillers, Sculptra, Oligio RF and Ultherapy.
Dermal fillers involve the injection of a hyaluronic acid gel into the face, providing immediate volume replacement and a gentle lifting effect. Strategically and precisely injected, fillers can sculpt, lift and volumise the face. Common treatment areas for fillers include the temples, cheeks and undereye.
Sculptra is a collagen biostimulator which stimulates skin cells to produce new collagen and elastin- this improves skin quality and results in firmer skin with fewer fine lines and sagging. Sculptra is often injected into the temples and cheek area to tighten the skin of the face, providing a gentle lifting effect known as the “Sculptra Liquid Facelift”
Oligio RF is a monopolar radiofrequency (RF) device designed for non-surgical, no-downtime skin tightening and lifting. Using high-frequency RF (6.78MHz), Oligio RF targets sagging skin, wrinkles, and fine lines by stimulating collagen production and improving skin elasticity
Ultherapy utilises MicroFocused Ultrasound with Visualisation to deliver focused ultrasound energy to the skin. The treatment causes existing collagen to contract and triggers new collagen production- resulting in immediate visible skin tightening and face lifting that further improves over the next 1-2 months.
A patient once joked “after 40 years old, you have to choose between your body or your face!” referring to the observation that you either have a chubby body with a youthful-looking face (still full of facial fat) or a lean body with a sunken and older looking face. With GLP-1 medications such as Ozempic trending, it is likely that treating “Ozempic Face” will be soon part of the medical school syllabus.
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