Approximately two years ago, Dr. Paul Jarrod Frank, a prominent cosmetic dermatologist in New York, began noticing a significant shift in his patient demographics. As more Americans turned to weight-loss drugs like Ozempic, he experienced a marked increase in patients reporting undesirable side effects. “Although they felt much better losing weight, in some ways they felt they looked older,” he explained. This perception, attributed to facial volume loss, led Frank to coin the term “Ozempic face” to characterize this emerging trend.
The phenomenon, which has gained traction on social media, reflects the sagging skin and sunken appearance that can accompany the use of GLP-1 medications, including semaglutide—found in Ozempic and Wegovy. Dr. Frank noted, “Usually, with people from their mid-40s and above, once you start losing 10-plus pounds, you can get this kind of deflated look,” particularly in those who lose 20 to 30 pounds or more. “You can only refill a deflated balloon so much, and often surgical intervention is necessary,” he added.
Semaglutide works by stimulating the pancreas to produce insulin, leading to reduced appetite and increased feelings of fullness. Although originally approved by the FDA for treating type 2 diabetes, many doctors are now prescribing it off-label for weight management. According to a 2024 report from health policy nonprofit KFF, about 1 in 8 U.S. adults has used a GLP-1 drug, with around 40% doing so primarily for weight loss.
Currently, more than 20% of Dr. Frank’s patients have incorporated GLP-1 medications into their health regimens, often seeking cosmetic treatments such as injectable fillers, facelifts, and fat transfers to restore facial volume lost during weight reduction.
The American Society of Plastic Surgeons (ASPS) recently reported that 40% of its members’ GLP-1 patients are considering cosmetic surgery, while 20% have already undergone procedures. One of these patients is Kimberly Bongiorno, a land use administrator from Mount Arlington, New Jersey. After losing weight due to gastric sleeve surgery in 2019, she gained 40 pounds during the COVID-19 pandemic and began taking Wegovy last year. Despite calling the drug’s effects “almost a miracle”—with her weight dropping from 170 to 125 pounds—she became concerned about her appearance.
“Everything just kind of hung and was very loose,” she recalled, sharing her dismay after seeing her face in a friend’s photo. “It looked like I had melted. It was horrifying.”
Following a consultation with Dr. Anthony Berlet, Bongiorno underwent a deep plane facelift and neck lift to address the excess skin resulting from her weight loss. “Before I did this, I probably looked closer to 60, or maybe even older. And now I have people who I’ve recently met think I am in my 40s,” she noted, expressing her relief at receiving compliments about her health and happiness.
Data from ASPS highlights an 8% increase in facelifts performed in the U.S. between 2022 and 2023, as well as a doubling of hyaluronic acid filler use—from 2.6 million in 2017 to over 5.2 million in 2023. While the organization couldn’t attribute these increases solely to GLP-1 drugs, former ASPS president Dr. Steven Williams acknowledged the widespread impact these medications are having on aesthetic surgery practices.
Dr. Williams emphasized that GLP-1 medications provide a new, effective tool for patients, allowing for meaningful conversations about weight loss and cosmetic outcomes. “We can now have an honest conversation with patients about a nonsurgical tool that’s effective in weight loss,” he said, reminding them to prepare for the changes that come with losing significant weight.
The term “Ozempic face” may encapsulate current trends, but the underlying issue of facial volume loss due to weight reduction is longstanding. Dr. Williams explained that adults do not generate new fat cells; instead, existing cells simply fluctuate in size. Consequently, weight loss results in a reduction of facial fullness.
Age also plays a significant role in how individuals respond to weight loss. Dr. Frank noted that younger patients in their 20s and 30s, such as 29-year-old Gabriela Vasquez, who has lost around 50 pounds since starting Ozempic, are less likely to exhibit aging due to weight loss. Vasquez is pursuing preventive cosmetic treatments like Botox and microneedling to combat the visible effects of weight loss.
Despite the benefits GLP-1 medications offer, the ASPS has coined the term “Ozempic makeover” to describe a suite of procedures aimed at addressing the physical changes caused by significant weight loss.
However, ongoing studies reveal that a large number of patients using these medications for weight loss discontinue them within a year. Recent research has indicated that many individuals regain their initial weight within 10 months after ceasing the treatments, prompting discussions about the necessity of a comprehensive approach to sustained weight loss.
Dr. Williams expressed concerns that plastic surgeons must take a holistic view of their patients’ weight-loss journeys. “We don’t want these patients to be on these medications for a lifetime. We want it to be a temporary bridge to a healthier lifestyle,” he remarked, underscoring the importance of integrating lifestyle changes and muscle-building exercises into patients’ plans.
