Ozempic, a type 2 diabetic drug, is the newest weight loss craze. On TikTok alone, hashtags like #ozempic and #ozempicweightloss have over 703 million views and counting, and high demand has resulted in shortages of the prescription-only medicine as well as its obesity treatment counterpart Wegovy.
With 4.5 million views as of mid-February, another hashtag is trending: “Ozempic face.” The term, coined by New York City dermatologist Paul Jarrod Frank, MD, refers to a side effect of the medicine, as well as rapid weight reduction in general: face aging, including gauntness and skin drooping.
According to David Shafer, MD, a New York City plastic surgeon, “Ozempic face” is a name developed for media shock value and attention but, at its core, is nothing new. “When we age and lose weight, we often lose weight in our faces, resulting in skin laxity,” Dr. Shafer explains. “This isn’t something unique to Ozempic. Any method of weight loss would result in the same problem.”
How Weight Reduction Affects Skin
Significant weight reduction (typically 35 or more pounds) in a short period of time (generally six months or less), according to Michele Koo, MD, a plastic surgeon in St. Louis, depletes the skin and body of important nutrients and can alter the endocrine and GI system homeostasis, or balance. “The skin thins and loses suppleness and shine as a result of the quick and rapid depletion of the necessary fatty acids that comprise the skin barrier function,” she explains. “Its collagen and elastin metabolism is also disturbed, leading to even more sallow, lifeless, and thin skin.” Rapid considerable weight loss is also associated with volume or fat reduction in the malar and submalar areas — that is, the cheeks.
Dr. Koo says that skin abnormalities are caused mostly by a lack of nourishment and vitamin deficiency over a short period of time. “Fat is reabsorbed and atrophies, exacerbating the old, gaunt appearance.”
“Consider a balloon filled with air. Even if you let a little air out, the balloon remains tight. Yet, when more air is evacuated, the balloon becomes slack, and the balloon’s elasticity cannot compensate for the loss of air volume,” Shafer explains. The body and face experience a similar reaction. “As our weight fluctuates, our skin may compensate by stretching and recoiling due to elastin fibers at the cellular level. Our ability to contract declines as we age, and we also lose volume, resulting in skin laxity.”
Lips can lose part of their fatty tissue mass as they age, but also as they lose weight, says Shafer. “This causes them to appear dehydrated or withered.”
According to Nazanin Saedi, MD, the department co-chair of the laser and aesthetics surgery center at Dermatology Associates of Plymouth Meeting in Pennsylvania, some persons with facial fullness prefer to lose some of the volumes in their face. (One contemporary dermatology fad is buccal fat reduction, which tries to remove baby fat in the cheeks and can give patients a leaner, gaunt-looking face.) Some dislike losing volume in this area of the body because it makes them look older.
If losing weight was your aim, you may be content with the way your skin has altered since then, whether you have “extra skin” on your face or stretch marks on your stomach, for example. If you’re unhappy with the way your skin appears right now, the good news is that there are a range of treatments available, ranging from over-the-counter medications to noninvasive and invasive expert procedures.
OTC Skin Care Products to Improve Skin Look After Weight Loss
A good diet, sufficient hydration, not smoking, and protection from harmful sun rays are all effective techniques for improving skin appearance following weight loss, according to Shafer.
According to Kathleen C. Suozzi, MD, an associate professor of dermatology at Yale School of Medicine in New Haven, Connecticut, and the director of the cosmetic dermatology department at Yale Medical, there are no over-the-counter (OTC) options for replenishing facial volume. “Treatments that promote healthy, supple skin can help to counteract the aging effects of volume loss, but they cannot lift or fill the face.”
A retinoid, according to Dr. Saedi, is the most effective over-the-counter medication for aged skin. “Retinoids assist enhance the texture of the skin and the appearance of crepey skin,” she says.
Shafer also recommends a medical-grade skin-care regimen that includes bioactive substances such as tretinoin, a retinol derivative.
When Should You Visit a Plastic Surgeon or a Dermatologist?
If over-the-counter products aren’t correcting undesired skin laxity caused by weight reduction, visit a professional.
“Plastic surgeons and dermatologists are skin and body experts,” adds Shafer, whose Shafer Clinic offers surgical and noninvasive skin treatments. “When standard home care, diet, and exercise fail to address a patient’s issues, it’s time to contact a doctor.”
Therapies for Enhancing Skin Following Weight Reduction in the Workplace
Many therapies can assist improve skin following weight reduction, and the best strategy for you will depend on your specific requirements.
Fillers for the Skin
According to Shafer, Juvéderm, and Restylane dermal filler is one of the most effective and immediate treatments for volume loss caused by facial weight reduction. The most popular are hyaluronic acid fillers, such as Juvéderm and Restylane. There are several forms of dermal filler.
Shafer recommends Juvéderm Voluma XC for the cheeks and Juvéderm Volux XC for the jawline, both of which have been authorized by the U.S. Food and Drug Administration (FDA) for increasing volume to these specific locations. (Volux is the only hyaluronic acid filler authorized by the FDA for the jawline.)
“Although these are not permanent cures, dermal fillers can produce extremely attractive and natural results when injected by expert injectors,” Shafer explains.
Restylane Contour was approved by the FDA in 2021 for the midface and cheeks, while Restylane Lift was approved in 2018 for cheek augmentation and treatment of age-related midface contour defects.
The effects of these fillers can endure anywhere from six months to two years, “but ‘lasting’ does not mean the complete effect is present for the entire period,” Shafer says. “If a filler is supposed to last two years, I recommend topping up after one year. Hence, if you used two syringes to achieve your maximum benefit during your initial treatment, you may only require one syringe per year to sustain the results. Because everyone’s bodies metabolize differently, patients should be aware that a filler may last longer or shorter in different persons.”
The average cost of hyaluronic acid filler (including Juvéderm and Restylane) is $684 per syringe, according to the American Society of Plastic Surgeons. But, face fillers “are not a beauty procedure in which you can expect to get a reasonable price for a job professionally done,” according to Shafer, so don’t try to haggle. “Dermal fillers are a tool, but going to a board-certified practitioner who has been thoroughly researched can influence the outcome.”
According to Shafer, calcium hydroxylapatite (Radiesse) and poly-L-lactic acid (Sculptra) are two other dermal fillers that differ from the more popular hyaluronic acid fillers Juvéderm and Restylane.
“Radiesse contains gel microspheres that not only enhance volume but also promote natural collagen,” he explains. In that it can be utilized for precision injections and definition, it is most similar to hyaluronic acid fillers. It lasts between one and two years.
“Sculptra also works by encouraging natural collagen formation under the skin,” he explains, adding that it may take several sessions to achieve complete effects. Once your goals are met, Sculptra can last two to three years and is superior to Radiesse for generalized filling.
“The cost will be determined by how much you do and how many treatment sessions you require to achieve your desired results,” explains Saedi. They are usually around $1,000 per syringe, and patients will require numerous syringes per visit.
Lasers and Other Energy-Related Devices
Brilliant radiofrequency micro needling Radiofrequency is a relatively recent energy technology, with fractionated radiofrequency, such as Genius, being even more so. According to Shafer, the FDA cleared it for use on the face and body in 2019.
The following is how radiofrequency works: “Tiny needles puncture the skin and transfer electricity beneath the surface, stimulating collagen and tightening the skin,” he explains. “The microneedles penetrate and cure levels that lasers cannot.”
While one treatment is normally sufficient, two to three sessions may be required. Costs begin at $3,500 but vary by treatment area and are sometimes lowered in packages.
Resurfacing utilizing fractionated CO2 Shafer refers to CO2 lasers as “the workhorse for skin tightening” because they have over 100 FDA-approved uses in 10 medical areas, including dermatology, plastic surgery, and gynecology. CO2 lasers were cleared by the FDA in 2004.
Although downtime can last up to two weeks because these lasers treat the skin’s surface layers, “the results can be substantial on fine wrinkles and pigmentation,” adds Shafer.
Costs begin at $3,500 and vary according to body region and skin laxity; typically people require one treatment per year. “Furthermore, patients should be prepared for a lengthier recuperation time than with technologies that focus the energy deeper,” he says, adding that mixing treatment modalities can produce greater outcomes than using only one type of treatment. “It is also crucial to remember that energy-based skin tightening, including CO2 lasers, is not the same as surgical skin tightening. Energy therapies cannot achieve the degree of tightness that surgical excision can.”
Sofwave or Ulthera? (micro-focused ultrasound) Ulthera was licensed by the FDA in 2014 to alleviate lines and wrinkles in the low neckline or décolleté, as well as raise the brow, chin, and neck area. The software has been FDA-approved since 2020 to alleviate fine lines and wrinkles on the face and neck, and a new indication for lifting areas around the brow, neck, and under the chin was added in 2021.
According to Shafer, micro-focused ultrasonic therapies like these use ultrasound energy to induce collagen creation beneath the skin’s surface. Because collagen production takes time, results may take two to three months, or even up to six months.
The process takes 30 to 90 minutes, depending on the region treated, and there is no recovery period. Treatments begin at $2,000 and vary according to body area. “The majority of patients only require one treatment; however, depending on how much skin laxity they have and their body’s own biological response to the ultrasound and the collagen-building process,” he explains.
Annual Ultherapy or Sofwave treatments may assist to preserve benefits.
Alternative Skin Care Treatments Following Weight Loss Renuvion In 2022, the FDA approved this procedure, which employs helium plasma energy to tighten the skin around the neck.
The one-time procedure is conducted under local anesthetic under the skin using tiny incisions; recovery time is moderate, ranging from one to three weeks.
Plasma energy, when delivered under the skin during liposuction surgery, aids in skin tightening in the neck and across the body.
“When used externally, plasma energy stimulates skin tightening,” Shafer explains. “Usually, each area only needs to be treated once, although the body continues to age as with any treatment. Hence, while the treatment does not stop the aging clock, it does assist reverse it as time passes,” he says. The typical cost is roughly $6,000.
The Renuvion Dermal Handpiece has also been approved by the FDA for treating moderate to severe wrinkles and rhytides in individuals with Fitzpatrick Skin Types I, II, or III. These are the skin kinds that are more likely to burn than tan.
Transfer of fat According to Dr. Koo, fat transfer is another option for plumping up the face following rapid weight loss. This treatment entails taking fat from the hips or abdomen, washing it, and reinjecting it into the cheeks, beneath the eyes, around the lips, and in or around the chin, mouth, or temple areas. “Fat can be added wherever there is a deficiency. “Due to the possibility of fat embolism and odd distortion, certain places (under the eyes) require little amounts disseminated out over the entire area,” she explains.
Fat injections for the face should be done a few cell layers at a time, as a thin layer enhances cell survival. As a result, depending on how many and which regions are treated, as well as how much fat is transferred, numerous sessions may be required. Another advantage of transferring fat gradually is that it ensures a slower, more gradual shift in volume rather than a one-time massive expansion, “which might distort and significantly modify facial shape in a very short period,” says Koo.”You don’t want to erase the regular anatomy; you want a soft-plumped version of yourself rather than a blown-up one.” The cost varies depending on location, but anticipate paying between $2,500 and $10,000 for every treatment, depending on the volume injected. Because of the higher dangers, delicate areas around the eyes or nose require more time, skill, and care, so expect to pay extra.
A neck lift or facelift Filler may not be enough for people in their late fifties and early sixties, and volume replenishment may necessitate plastic surgery, according to Suozzi. To address post-weight loss skin issues, plastic surgery can be performed practically anywhere on the face and body.
Facelifts and neck lifts are the next phases, according to Shafer. “The underlying muscle is tightened, the underlying fat is moved and occasionally increased, and finally the skin is tightened,” he explains. “Patients are frequently pleasantly pleased by the recovery and spectacular but natural-looking outcomes.”
Costs range from $25K to more than $100K, depending on the nature of the surgery and who does it; where you receive treatment can also influence pricing. The most significant advantage is that the outcomes are long-lasting.
While reducing weight quickly may seem enticing, Suozzi cautions that any sort of rapid weight loss might result in the appearance of accelerated facial aging. “These are the effects of facial fat loss, not changes in the skin,” she explains. Fast weight loss can also cause drooping skin on other regions of the body, such as the neck and arms.
Some persons with facial fullness choose to lose part of the volume in their face, according to Saedi, mentioning buccal fat reduction as an example. “Several celebrities, like the Kardashians and Chrissy Teigen, have made public statements about having their buccal fat pads (sub malar fat) removed to obtain a more angular, refined aesthetic vs a round facial look,” explains Koo.
If you do decide to pursue alternative choices, Shafer recommends finding a board-certified plastic surgeon or dermatologist to do the job well, even if it means spending a bit extra money.