At Dallas dermatologist Elizabeth Houshmand, MD’s practice, there’s been an influx of patients making appointments for one specific concern: hair loss due to GLP-1 use.
“I am seeing more patients for hair-loss consultations due to GLP-1 use,” she says. “It is basically a telogen effluvium, and I am using PRP, supplements and blood work to evaluate.”
Calling GLP-1 use the “rage around the world,” Montclair, NJ dermatologist Jeanine Downie, MD says she thinks it’s accurate to say at least 40 percent of her patients are on GLP 1 medications, and the “strand stats” are staggering.
“Of that 40 percent, easily half of them have hair loss, so I am recommending Nutrafol, ISDIN’s Lambdapil shampoo and spray, DefenAge 150K Hair Follicle Serum, the Keralase hair-restoration laser,” she says. “It is all hands-on-deck to keep hair on the head because this is underreported, but is occurring in 50 percent or more of my GLP-1 patients.”
As for timing, Dr. Houshmand says that no one is coming in preemptively—although she wishes they would. “They come in after being on the meds for several months and start to notice hair loss, as well loss of volume or laxity of their skin on both the body and face.”
For that second “loss”—that of volume—Dr. Houshmand notes she is doing “a lot of biostimulators, like Sculptra, and combination therapy with fillers and neurotoxins.”
Encino, CA plastic surgeon George Sanders, MD is also a fan of facial fillers for this category of patients when it comes to noninvasive options. “With the use of GLP-1 agonists, rapid weight loss frequently occurs, leading to loose and stretched skin,” he explains. “Microneedling and/or radiofrequency treatments will also tighten lax skin, and the use of fillers to provide necessary soft tissue support is also helpful.”
Pasadena, CA facial plastic surgeon Dr. Kay Durairaj also praises fillers (specifically, Radiesse) for preserving facial volume in GLP-1 users, and published a report this week in the Aesthetic Surgery Journal Open Forum that backs their efficacy.
In the case series, four patients taking GLP-1 medications received treatments with a hyperdiluted form of calcium hydroxylapatite (CaHA), known commercially as Radiesse. Even though participants lost an average of 24 pounds—about 9 percent of their body weight—their faces didn’t show the typical signs of volume loss. In fact, cheek volume increased by nearly 10 percent, while jowls and smile lines visibly softened. At the six-month mark, every patient reported satisfaction with their results, and all were rated by investigators as “improved” or “much improved.”
On Phoenix dermatologist Dr. Karan Lal’s list for GLP-1 users: Sofwave and Ultherapy Prime, to start. “They are both ultrasound technologies that are noninvasive that can provide lifting and tightening for up to six months,” he explains. “I also really like Renuvion—it is a minimally invasive device that coagulates tissue and is my go-to for GLP-associated sagging. It is done in the office or it can be done with liposuction. It can tighten up to 60 percent of the skin.”
Dr. Lal also has found good success with hyaluronic acid fillers in GLP-1 patients. “I personally love Juvederm Voluma for structure and Vollure for fine lines,” he says. “EMFACE by BTL can also help with lifting.”
In regards to equipment, Dr. Downie says she likes to use the “IntraCel radiofrequency/microneedling for decreasing fine lines and deep lines, as well as improving pore size and texture, the IntraGen to tighten the skin, the Zaffiro for skin-tightening and the EMSCULPT Neo for fat melting, core tightening and droopy-butt lifting.”
As expected, beyond the butt, the body is also a prime area to pinpoint. In fact, for the first time, the 2024 American Society of Plastic Surgeons (ASPS) Procedural Statistics Report (released over the summer) measured the prescription of weight-loss medications by its members, with more than 800,000 aesthetic patients utilizing them to support their health goals in 2024.
The findings: Twenty percent of GLP-1 patients under the care of ASPS Member Surgeons have already undergone plastic surgery, while 39 percent are considering a surgical procedure and 41 percent are considering a nonsurgical procedure. While not a substitute for weight-loss surgery, the report also noted that body-contouring procedures “can help GLP-1 patients achieve balance, improved functionality and enhanced self-esteem.”
What is also helpful, says Nashville plastic surgeon Daniel A. Hatef, MD is for patients to consider microdosing. “Patients who are on GLP-1 agonist peptides are sometimes experiencing such an aggressive decline in their body fat that they can begin to look ‘hollow.’ Although we love fat grafting and off-the-shelf fillers like Sculptra, Renuva and Alloclae, the main thing we tell patients is that it is time to start decreasing the dose and or frequency of their medication,” he says. “At our office, we only microdose, so our patients typically do not get to this stage. When we are seeing patients whose GLP-1 agonist use is being managed in a more aggressive manner, we recommend that they start to level off their weight loss and coordinate with their prescribing physician to help land the plane, so to speak.”
