The Ozempic Bod Gets Trimmer, ‘Ozempic Face’ Gets Older | AAO 2024

Many people are taking the glucagon-like peptide 1 (GLP-1) drugs to slim down their bodies for health and cosmetic reasons, but they may not be so happy about what the rapid weight loss from the drugs may do to their faces.

"When we lose fat, the structural support of the face diminishes, leading to a sadder appearance," said Jeremiah Tao, M.D., at the 2024 annual meeting of the American Academy of Ophthalmology (AAO) in Chicago.

Tao, the chief of oculofacial plastic and orbital surgery at Gavin Herbert Eye Institute at the University of California, Irvine, was describing what has come to be called “Ozempic face.”

The weight loss from the GLP-1s results in loss of fat from various sections of the face ways similar to those experienced normal aging, he explained during a “hot topics” session at the AAO meeting on Saturday.

The facial features most affected by both aging and rapid weight loss are prolapsed orbital fat, the palpebromalar groove, the malar bag, and the mid face groove. Other signs associated more specifically with Ozempic face include hollowed areas on the face, increased wrinkles, changes in lip size and sagging jowls.

"Understanding facial anatomy is essential,” said Tao. “Volume loss affects not only the skin but also underlying structures like the bony skeleton and ligamentous attachments, contributing to common issues like dark circles under the eyes."

Tao said some people perceive their faces as looking 5 years older after rapid weight loss. To illustrate the point, he showed a side-by-side picture of balloon with a smooth surface when it is inflated and a wrinkled one after it is deflated.

But Tao advised against putting weight loss in reverse to deal with Ozempic face: “You’re probably not going to look younger if you’re gaining weight back, so it’s essential to communicate this to our patients," he said.

Jeremiah Tao, M.D.

“When we talk about GLP-1 receptor agonists, we're not just discussing weight loss; we’re addressing the aesthetic implications of rapid changes in body composition,” Tao told the AAO audience. “Patients are eager for aesthetic facial treatments, but we need to consider the timing, especially if they are also undergoing significant weight loss.”

If cosmetic approaches are sought to correct Ozempic face, Tao recommended waiting until the weight loss goal was achieved or treatment was discontinued. Some nonsurgical options include tear trough corrections with fillers, although caution must be used around the eyes because the skin is thin there, Tao said. He also recommended skin tightening with microneedling, radiofrequency or CO2 laser. Surgical options include brow lifts, blepharoplasty and various other face lifts.

Another choice is autologous fat grafting, which involves taking fat from another part of the body and placing it under the skin in face. "Fat grafting has gained popularity over the last two decades, and while I may not perform it often, it could be beneficial in addressing the underlying changes associated with weight loss and aging," said Tao.

The first GLP-1 to generate excitement about weight loss was semaglutide, which at the time was marketed as Ozempic. It was approved by the FDA as a treatment for type 2 diabetes but was often used off-label for weight loss and became widely known for that use. FDA approved semaglutide for weight management in 2021, and it is sold under the brand name Wegovy for that purpose.

Tirzepatide is another GLP-1 approved for weight loss. It is marketed as Zepbound for that purpose and as Mounjaro for type 2 diabetes management.