GLP-1 medication can be a wonder worker for those looking to lose weight from the neck down, but did you know you can also lose youthful volume in your face? This can make lines and wrinkles look more pronounced, and even result in a saggy, crepey look. Luckily, there are dozens of in-office treatments available to smooth creases, restore volume and lift sagging skin, all without going under the knife. Here, a leading dermatologist and facial plastic surgeon weigh in on the top options—neurotoxins like Botox Cosmetic, fillers and thread lifts—and the best order to do them if a combination approach is the right fit for you.
Featured Experts
- Jessie Cheung, MD, a board-certified dermatologist based in Willowbrook, IL
- Kay Durairaj, MD, a board-certified facial plastic surgeon based in Pasadena, CA
The order matters because filler supports, toxin smooths, and threads lift,” says Pasadena, CA facial plastic surgeon Kay Durairaj, MD. “If done out of sequence, you can create tension or imbalance instead of harmony.” Willowbrook, IL dermatologist Jessie Cheung, MD adds that the timing is just as important as the order, too. “The best time to start these treatments is while you’re losing weight,” she explains. “Supporting the skin’s collagen and elasticity during the process helps prevent the sudden laxity and hollowing that can show up once the pounds are gone. Weight loss can mimic accelerated facial aging.”
Dr. Durairaj says many GLP-1 patients benefit from this combination approach, especially those with significant facial deflation. “These patients often present with flattened cheeks, deep nasolabial folds, marionette lines, jowling and laxity in the lower face,” she explains, noting that a proactive approach helps patients maintain facial harmony throughout their weight-loss journey rather than waiting until significant deflation occurs. “Filler addresses hollowing in the cheeks, temples, jawline and perioral area. Toxin softens etched lines. Threads provide subtle lift and definition, particularly along the jawline and midface.”
Facial Procedures After GLP-1 Weight Loss: The First Step
“After GLP-1 weight loss, the first priority is usually re-establishing facial structure and support,” says Dr. Durairaj. “Rapid fat loss can lead to hollowing in the midface, loss of jawline definition and skin laxity. I typically start with biostimulatory treatments or fillers to rebuild volume and recontour the face before addressing lines or lift. If the scaffolding isn’t restored first, other treatments like neuromodulators or threads can look less balanced or even accentuate hollowness.”
Dr. Cheung agrees, noting she prefers biostimulatory fillers such as hyperdilute Radiesse or Sculptra. “These treatments stimulate collagen and elastin to rebuild the skin’s internal structure and improve quality, which is crucial, because weight loss isn’t just about losing fat; it also changes the skin’s texture and resilience. Once we’ve created healthier, more supportive tissue through biostimulation, that tissue will hold a thread lift better and give a more lifted, lasting result.”
Once a patient’s weight stabilizes (usually after a few months), or if visible hollowing develops, Dr. Durairaj adds that additional filler (like hyaluronic acid) can be “layered in strategically” to restore natural contours in areas like the midface, temples or jawline. “By starting with biostimulation, we often need less filler overall, and results look softer and more lifted because the underlying structure is already reinforced.”
The Second Step: Neurotoxins
After volume replacement, Dr. Durairaj often uses neurotoxins [Botox Cosmetic, Dysport, Jeuveau, Letybo and Xeomin] to relax dynamic lines especially in the forehead, glabella (11s) and crow’s-feet. “This softens expression lines that can look more prominent after weight loss,” she says. Though Dr. Cheung adds that neurotoxins can be done anytime, she always recommends doing them “prior to a thread lift to reduce excess muscle pulling and protect your results.”
The Third Step: A Thread Lift
Last but not least, a thread lift can be performed to reposition loose skin and restore a more youthful facial contour. “The threads will create even more scaffolding for new collagen,” says Dr. Cheung. “I can then see where true volume loss remains, which I will correct with hyaluronic acid fillers. This is usually in areas that don’t lift, like the temples, lips and chin. I find that once the face is lifted and supported with a thread lift, I need to inject less filler overall, which means more natural-looking results.”
Dr. Durairaj adds that “threads work best on a well-structured foundation, so doing them too early can lead to a less natural or short-lived result.” This reiterates the point about following an expert-recommended order of procedures, which a board-certified dermatologist or plastic surgeon can advise. “Ultimately, my goal is to help patients look as vibrant and confident as they feel, and to bring their face back into harmony with the body they’ve worked so hard to achieve,” says Dr. Cheung.
Additionally, though these three treatments can work wonders for facial changes after GLP-1 weight loss, Dr. Durairaj says good topical skin care and lifestyle support are also important to enhance outcomes. “It’s not just about replacing lost volume; it’s about preserving and optimizing skin health along the way.”
