The phrase “Ozempic face” may have exploded on social media, but the facial changes it describes like hollowed cheeks, flattened contours and sagging skin aren’t new. Surgeons have long seen them in patients who experience rapid, significant weight loss. What’s new is the speed and scale of transformation made possible by GLP-1 medications like Ozempic, Wegovy, Mounjaro and Zepbound, and the fact that many patients are younger and otherwise healthy when these shifts appear.
Featured Experts
- Philippe Capraro, MD is a board-certified plastic surgeon in Denver
- Jacob Beer, MD is a board-certified dermatologist in West Palm Beach, FL
- Joseph Russo, MD is a board-certified plastic surgeon in Newton Centre, MA
- Johnny Franco, MD is a board-certified plastic surgeon in Austin, TX
- Ruth Hillelson, MD is a board-certified plastic surgeon in Denver
Why Facial Changes Happen
Fat loss in the face can be both dramatic and uneven. Denver plastic surgeon Philippe Capraro, MD notes that patients who have shed 100 pounds or more often present with sagging skin that simply can’t contract fast enough to match the deflation underneath. “Skin simply can’t contract fast enough,” he explains. “In order to get a long-lasting, natural result, we have to look at restoring both volume and skin support,” he says.
The name may be catchy, but Newton Centre, MA plastic surgeon Joseph Russo, MD believes it blurs the real cause. “It’s not because of the drug. Most of aging is related to volume loss,” he explains. “When you have a massive or sudden weight loss, it draws attention to that because you’re taking away volume from an area that was previously full.”
West Palm Beach dermatologist Jacob Beer, MD agrees that the root cause is a rapid deflation of facial fat pads and even underlying bone support. “In general, we start to lose fat and lose bone in our face past the age of 30,” says Dr. Beer. “Things that exacerbate that are illnesses or rapid weight loss.” He notes that early signs include temple hollowing and tear-trough formation, changes that can make the face look tired or drawn. “That’s what most patients pick up on first, especially in the temples,” he says.
Nonsurgical Treatments for “Ozempic Face”
Patients in the middle of their weight-loss journey or those with only mild changes can benefit from early, targeted treatment. Collagen-stimulating injectables like Sculptra and Radiesse can replenish structural support while improving skin quality over time. For restoring shape and definition, hyaluronic acid or calcium hydroxyapatite fillers can be placed strategically in the cheekbones, jawline or temples.
Dr. Beer says his ideal approach is to combine prevention and restoration. “For my GLP-1 patients, I like to get ahead of it,” he says. “If someone comes in and says, ‘Do what you’d do for your sister or mom,’ I’ll start with Sculptra in the temples and cheeks.” He likes that it works gradually. “They start to lose fat over a few months, which is exactly when the Sculptra will start kicking in.”
He also sometimes pairs collagen stimulators with hyaluronic acid fillers for an immediate and long-term effect. “If a patient’s already noticing volume loss, I’ll start with HA filler to give them instant support,” says Dr. Beer. “Then, when that starts to go down, the Sculptra kicks in and keeps them in the same place.”
Tightening and Texture
Skin-tightening technology offers another layer of defense. Radio-frequency microneedling devices such as Morpheus8 and ultrasound-based treatments like Ultherapy or Sofwave can subtly firm skin and improve elasticity. These options are especially effective, says Austin plastic surgeon Johnny Franco, MD, when combined.
“The last thing you want to do is overfill,” he notes. “Tightening, adding biostimulants and giving structural support to areas like the jawline or cheekbones is super powerful.”
Dr. Beer adds that texture is often an overlooked part of the equation. “We’re seeing that skin quality actually takes a hit during weight loss,” he says. “There have even been biopsy studies showing the dermis can thin and lose collagen.” To improve this, he recommends resurfacing lasers like the 1927 nm and 1550 nm wavelengths. “Lasers really help with texture,” he says. “If someone’s not a laser candidate, even starting off with a light peel can make a big difference.”
Richmond, VA plastic surgeon Ruth Hillelson, MD has noticed more dryness, dermal thinning and surface irregularity in rapid weight-loss patients. She recommends pairing disciplined at-home care—cleansing, quality topicals and daily sunscreen—with in-office collagen stimulators such as Thermage, Morpheus8 and Tixel, sometimes enhanced with growth-factor-rich serums.
The Case for Prevention
The most effective approach is to act before the changes become pronounced. Dr. Beer calls this “collagen banking.” “Whatever you can do to help your texture and collagen early is key,” he says. “That’s why I like using biostimulators, light resurfacing and lasers, it’s about preserving structure while the weight is coming off.”
Dr. Franco, who has personally lost more than 80 pounds on a GLP-1, echoes this point: “If I could change one thing in my own weight-loss journey, I would have started treatment sooner. We talk about a prevention plan at the initial GLP-1 consultation so patients know what to expect.”
Surgical timing also matters. Dr. Capraro advises waiting until weight has been stable for at least six months before considering a major lift. “If they’re still losing, they risk additional laxity after the procedure, which can mean they’ll need surgery again down the line,” he explains.
When It’s Time to Consider Surgery
If no amount of injectables or devices can fully correct the combination of severe volume loss and significant skin redundancy, then surgery becomes the most predictable and comprehensive option. A facelift and necklift, often paired with fat grafting, can restore youthful contours and tighten lax tissue.
As Dr. Capraro notes,“You have to evaluate the individual’s anatomy and how their weight loss has changed the foundation of the face. In some cases, a deep-plane facelift is needed to reposition the underlying muscles and fascia before re-draping the skin. If volume loss is severe, fat grafting to the midface, temples and jawline helps avoid that overly tight, unnatural look.”
He adds that the neck often needs its own attention. “With rapid weight loss, the platysma muscle can band and the skin can hang loosely. A necklift allows us to tighten the muscle, remove excess skin and restore definition to the jawline and chin.”
The Takeaway
Whether you call it “Ozempic face” or post-weight-loss facial change, the underlying issue is rapid fat and collagen loss. For patients on GLP-1s, prevention is the best correction, bank collagen early, support the skin barrier and combine tightening with regenerative treatments. As Dr. Franco puts it: “It’s about living your fit and fabulous life.”
