Implications of Ozempic and Other GLP-1 Receptor Agonists for Facial Plastic Surgeons

Abstract

Obesity is a growing global health concern, leading to various health issues, including diabetes. Semaglutide-based medications, such as Ozempic, Wegovy, and Rybelsus, have emerged as potential treatments. These medications, belonging to the GLP-1 receptor agonist class, mimic the action of GLP-1, regulating appetite and promoting weight loss. Clinical trials have shown their effectiveness in reducing body weight and improving metabolic parameters. Ozempic, though FDA-approved for diabetes, is also used off-label for weight loss alone. Rapid weight and fat loss with Ozempic can lead to the characteristic "Ozempic face," where facial volume and fat are depleted, resulting in wrinkles and sagging skin. Providers prescribing Ozempic seldom counsel patients about the potential impact on the face. As a result, the plastic surgery community faces a challenge in managing facial changes associated with rapid weight loss. Dermal fillers, skin tightening techniques, and surgical interventions are useful for both restoration of facial volume and to manage excess skin. Discontinuation of Ozempic should be considered prior to general anesthesia due to gastrointestinal side effects including delayed gastric emptying. As the popularity of Ozempic grows, facial plastic surgeons must be aware of both the impact on facial appearance and perioperative considerations.

Injectable Weight Loss Medications in Plastic Surgery: What We Know, Perioperative Considerations, and Recommendations for the Future

“…46 Unfortunately, even if patients experience weight regain, the fat will likely not distribute to a pre-weight-loss state, leaving them with persistent signs of facial aging. 45 Plastic surgeons have many options at their disposal to help combat these changes to facial morphology. Dermal fillers, fat autografting, and collagen stimulators can be used to re-volumize and resurface the temple, tear trough, midface, nasolabial fold, and jowl.…”

“…5 ). 45 In fact, patients who undergo massive weight loss can seem up to 5 years older than similarly aged people. 46 Unfortunately, even if patients experience weight regain, the fat will likely not distribute to a pre-weight-loss state, leaving them with persistent signs of facial aging.…”

“… 46 Unfortunately, even if patients experience weight regain, the fat will likely not distribute to a pre-weight-loss state, leaving them with persistent signs of facial aging. 45 …”

Letter to the Editor: Comment on Implications of Ozempic and Other Semaglutide Medications for Facial Plastic Surgeons

“…We read with interest "Implications of Ozempic and Other Semaglutide Medications for Facial Plastic Surgeons" by Humphrey and Lawrence. 1 We believe it is prudent to raise the following two points which should be taken into consideration by readers of this publication.…”

“…2 Second, Humphrey and Lawrence discuss weight loss throughout the body (including the face) following treatment with glucagon-like peptide-1 (GLP-1) receptor agonists, which can result in changes to skin properties and facial features, potentially causing an aged appearance and negative impact on self-esteem. 1 Indeed, it is known that the appearance of accelerated aging of the face can be an unintended consequence of rapid weight loss (for example, already well described following bariatric surgery), due to volume loss in the face and neck and reduced skin elasticity. 3 Apart from these effects, there are important health-related benefits that follow intentional weight loss, such as improvements in cardiovascular health.…”