GLP-1/GIP medication is the health topic that everyone’s talking about: who’s taking it, why they’re taking it, and who should actually be taking it in the first place. And that’s a complex situation. Some, like Mounjaro and Wegovy, are approved by the NHS for treating obesity as well as type-2 diabetes, while others, including Ozempic, can only be prescribed off-label for weight loss. But all GLP-1/GIP drugs have one thing in common: the potential for problems.
Alongside the general risks and contraindications, there’s alarm about people taking them unsafely for weight loss, from online fakes to people obtaining the real drugs by lying about their medical history. Then there are concerns from patients themselves, who are seeing consequences they didn’t expect in the mirror.
In short, the appetite-suppressing effects of GLP-1/GIP agonist drugs aren’t just seen on backsides and waistlines. ‘They aren’t a “magic bullet”. Fat loss can happen everywhere,’ says aesthetics doctor and psychiatrist Dr Galyna Selezneva, who estimates that around 50% of her clientele are currently taking these medications.
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‘It can lead to what’s being called “Ozempic face’’, with a hollowed-out appearance, sunken cheeks, skin laxity around the jawline and neck, and more visible wrinkles.’
Rapid fat loss isn’t the only factor in facial changes, notes Dr Galyna. ‘The weight that’s lost can also mean a loss of muscle, collagen and elastin, too. Patients might experience dropping in the mid-face, and even a weaker chin. This all has a huge impact on patients’ confidence. While they feel positive about the actual weight loss, they didn’t expect to look worse.’
Losing large amounts of weight may also lead to a slight decrease of oestrogen, which has its own impact, she adds. ‘Fat cells produce this hormone, so rapid weight loss may lead to drier, more fragile skin.’
The age profile of GLP-1/GIP users further compounds the issue of ‘Ozempic face’, notes aesthetics expert Dr Glyn Estebanez, one of Allergan’s practitioner trainers. ‘Many of these patients are in their 40s or 50s and entering perimenopause or menopause, which brings its own set of changes to skin, fat distribution, collagen loss and overall facial structure.’
Clinic confidential
All of this means that aesthetic doctors are now treating ‘Ozempic face’ cases at rocketing rates. ‘I think many people would be shocked by how prevalent GLP-1/GIP injections have become,’ says Dr Nyla Raja, dermatology GP and founder of Dr Nyla Medispa clinics. ‘I treat a number of celebrity and high-profile clients, and while discretion is key, I can confidently say that this is a much more common tool than most people realise.’
Admitting to GLP-1/GIP usage remains taboo for many users, whether they’re famous or not. However, Dr Nyla says the best way to mediate ‘Ozempic face’ is to be open with a skin specialist, if nobody else.
‘Ideally, it’s about prevention,’ she says. ‘If I know a patient is starting on medication, we can take a proactive approach to preserve skin quality, support collagen and maintain facial volume with subtle treatments. But more often than not, people come once the changes have already started – gauntness, sagging and skin that looks older than it should. That’s when we switch to restoration mode.’ Needless to say, the longer it’s left, the trickier it is to combat.
Saving face
So, what can you do about ‘Ozempic face’ if you’re contemplating GLP-1/GIP drugs, or are already using them? Start with lifestyle changes, advises integrative dermatologist Dr Raja Sivamani. ‘A high protein diet helps to preserve muscle mass including facial muscle mass. Facial exercises can be helpful to maintain muscle mass as well.'
Good skincare is key, he adds. ‘Daily sun protection alongside topical antioxidants will help to reduce sun-induced damage and collagen breakdown.’
Prevention should be paired with restorative skincare. ‘Retinoids can help to build up collagen and elastin over time,’ advises dermatologist Dr Alexis Granite. ‘Keeping the skin well hydrated with ingredients such as hyaluronic acid and ceramides can help skin appear firmer and more supple.’ GH likes Murad’s new Retinal ReSculpt Overnight Cream, combining retinoids with longevity molecule NAD+ to help lift sagging face and jowls.
You can now even buy the first dedicated ‘anti-Ozempic face’ cream, co-created by cosmetic surgeon Dr Marc Ronert to help replump patients. ‘For VOL.U.LIFT, we researched specific skin changes caused by GLP-1/GIP agonists, selected ingredients to address them, then completed clinical studies with current GLP-1/GIP users,’ explains Dr Ronert. ‘We saw a 20% increase in facial volume, a 22% increase in firming and 23% in elasticity, all in 12 weeks.’
And since the sagging doesn’t stop at the neck, products to tackle ‘Ozempic body’ are set to boom, too. The first batch of Dermalogica’s new Dynamic Skin Sculptor, a tightening body serum to combat laxity from rapid weight loss, sold out on the brand’s website within a week of launch.
Going deeper
Exciting innovations, for sure. But if you really want to make serious inroads into ‘Ozempic face’, it’s likely to require a multi-pronged approach.
‘Dependent on the patient’s concerns, we might include radiofrequency-based skin tightening like Morpheus8, biostimulators such as polynucleotides or exosomes, and strategic dermal filler placement to restore lost structure in a natural-looking way,’ says Dr Nyla.
And ‘natural’ is the key watchword here. ‘The goal is never to chase lines or fill every hollow, but to bring the face back into equilibrium in a way that respects the patient’s natural architecture,’ says Dr Glyn.
‘I use a multi-layered approach. Filler products like Juvéderm Voluma help rebuild the foundational structure of the mid-face and restore support without distortion, and are complemented by HArmonyCa injections for patients needing both collagen stimulation and additional tightness.’
At Dr Galyna’s clinic, combatting ‘Ozempic face’ is all about high-tech devices such as Sofwave and Sylfirm X to provide collagen stimulating and skin tightening results, combined with muscle-strengthening treatments such as EmFace to help shore up facial support. In the case of the latter, painless electronic facial pads stimulate collagen via radiofrequency while simultaneously forcing muscles to strongly contract.
To take a truly holistic approach, there are treatments for every body area potentially affected by rapid fat and muscle loss, including one you might not have considered. ‘I have GLP-1/GIP patients coming to me saying they’re noticing looseness in the labia and/or vagina, and incontinence from loss of pelvic floor muscle,’ says Dr Galyna.
It’s prompted the creation what’s been dubbed her ‘lady garden lift’ using the Cristal Fit reVive chair to tighten pelvic floor muscles, the intimate Exion Emfemme 360 wand for vaginal laxity, and NewGyn polynucleotide injections ‘specifically designed for the genital area’ to restore labia volume loss. As she puts it: ‘“Ozempic vagina” is a very real issue as well.’
